Anesthesia in Kawasaki disease-associated coronary artery aneurysmorrhaphy that required postoperative emergency coronary artery bypass grafting for myocardial ischemia with severe bradycardia

Abstract

　We provided anesthesia for Kawasaki disease-associated coronary artery aneurysmorrhaphy that required emergency coronary artery bypass grafting (CABG) for postoperative myocardial ischemia. The patient was a 43-year-old woman who was diagnosed with Kawasaki disease at the age of 12 years. She had developed chest pain and underwent CABG and right coronary artery aneurysmorrhaphy for complete occlusion of the left anterior descending coronary artery and a right coronary artery aneurysm. Severe bradycardia and hypotension occurred 7 hours postoperatively and she was diagnosed with myocardial ischemia in the perfusion area of the right coronary artery, for which extremely urgent CABG was successfully performed. Surgery and anesthesia for Kawasaki disease-associated coronary artery disease requires careful management with consideration of the effects of the vascular pathology characteristics of Kawasaki disease.