scholarly journals A Case of Kawasaki Disease Accompanied by Encephalitis and Several Kinds of Arrhythmia during the Acute Phase

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Naomi Nakagawa ◽  
Masahiro Kamada ◽  
Yukiko Ishiguchi ◽  
Yuji Moritoh ◽  
Kengo Okamoto ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Acute Phase ◽  
Arterial Switch Operation ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
High Dose ◽  
Sinus Arrest ◽  
Steroid Pulse ◽  
Arterial Switch ◽  
Switch Operation

Although central nervous system complications occasionally accompany during the acute phase of Kawasaki disease, clinically problematic arrhythmia is quite rare. We report a case accompanied by encephalitis and several kinds of problematic arrhythmia. Following the diagnosis of Taussig–Bing anomaly and coarctation of the aorta, the patient underwent aortic arch reconstruction, an arterial switch operation, and ventricular septal defect closure. No significant arrhythmias were observed. At the age of 5 years, the patient presented with a fever, rash, conjunctival hyperemia, and redness of the lips and fingertips. He was subsequently diagnosed with Kawasaki disease. The patient also presented with disorientation, and electroencephalography revealed overall slow-wave activity, indicating encephalitis. The patient received high-dose immunoglobulin and steroid pulse therapy. Sinus arrest was detected on day 10, and an atrial flutter with a 2 : 1 to 4 : 1 atrioventricular conduction block occurred on day 20. Although cardioversion succeeded in alleviating the atrial flatter, the patient experienced significant sinus arrest. The sinus arrest was alleviated 3 days later. Kawasaki disease-induced vasculitis and the arterial switch operation may both have influenced the sinus node dysfunction. Although sinus node function recovered, the possibility of progression into the sinus node dysfunction in the future should be considered.

Abstract 136: A Case of Complex Congenital Heart Disease with Postoperative Complications of Impaired Consciousness and Several Arrhythmias due to Encephalitis in the Acute Stage of Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Naomi Nakagawa ◽  
Masahiro Kamada ◽  
Yukiko Ishiguchi ◽  
Yuji Moritoh ◽  
Kenji Okamoto
Keyword(s):  
Kawasaki Disease ◽  
Aortic Arch ◽  
Atrial Flutter ◽  
Arterial Switch Operation ◽  
Cardiac Anomaly ◽  
Complex Congenital Heart Disease ◽  
Myocardial Inflammation ◽  
Sinus Arrest ◽  
Steroid Pulse ◽  
Severe Arrhythmia

Background: In addition to muscular and medium arteries, Kawasaki disease causes inflammation in nerves and the myocardium. However, arrhythmia severe enough to be problematic is rare. Patient: At age 1 day, the patient was in a state of shock and was diagnosed with Taussig-Bing anomaly and aortic arch coarctation. At age 4 days, he underwent aortic arch reconstruction and pulmonary arterial banding. At age 2 months, he underwent arterial switch operation and ventricular septal defect closure. No significant arrhythmias were observed. At age 5 years 6 months, he had a fever, and 5 days later, he developed rash, conjunctival hyperemia, and redness of the lips and fingertips. Kawasaki disease was diagnosed on day 7 after symptom onset. The patient presented with disorientation, so electroencephalography and magnetic resonance imaging were performed and revealed overall slow-wave activity and cerebral edema, respectively, indicating complicated encephalitis. Sinoatrial block and sinus arrest were also observed. The patient received ultrahigh-dose γ-globulin therapy and steroid pulse therapy for encephalitis. The fever resolved at a total γ-globulin dose of 4 g/kg. The other main Kawasaki disease symptoms also disappeared. By day 18, his consciousness completely recovered but the sinus arrest remained. On day 20, an atrial flutter developed from tachycardia that was treated with electric shocks. Sinus arrest at a maximum of 5.7 s was observed at that time, and bradycardia-tachycardia syndrome was suspected. On the same day, the sinus arrest improved gradually and largely disappeared 3 days later. The atrial flutter also disappeared. Discussion: Severe arrhythmia that requires treatment is rare in Kawasaki disease. Our patient underwent surgery for a complex cardiac anomaly. Thus, the requisites for arrhythmia were present when the Kawasaki disease caused myocardial inflammation, which is thought to cause severe symptoms.

Alternative pulmonary artery reconstruction technique in the arterial switch operation

2021 ◽  
Author(s):  
Hisayuki Hongu ◽  
Masaaki Yamagishi ◽  
Yoshinobu Maeda ◽  
Keiichi Itatani ◽  
Masatoshi Shimada ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Arterial Switch Operation ◽  
Late Complication ◽  
Late Complications ◽  
Reconstruction Technique ◽  
Reconstruction Method ◽  
Arterial Switch ◽  
Switch Operation ◽  
Longitudinal Extension

Abstract OBJECTIVES Late complications of arterial switch operations (ASO) for transposition of the great arteries, such as neo-pulmonary artery (PA) stenosis and/or neoaortic regurgitation, have been reported. We developed an alternative reconstruction method called the longitudinal extension (LE) method to prevent PA bifurcation stenosis (PABS). METHODS We identified 48 patients diagnosed with transposition of the great arteries and performed ASO using the Lecompte manoeuvre for neo-PA reconstruction. In 9 consecutive patients (from 2014), the LE method was performed (LE). Before 2014, conventional techniques were performed in 39 patients (C). The median body weight and age in the LE and C groups were 3.0 and 3.1 kg and 12 and 26 days, respectively. In the LE group, 1 patient underwent bilateral PA banding before ASO. In C, PA banding and arch repair were performed in 1 patient each. Patients who received concomitant procedures were included. RESULTS The median follow-up in LE and C groups was 1.9 and 10.1 years, respectively. Early mortality/late death was not found in group LE and in 1 patient in group C. Only 1 case required ascending aorta sliding plasty in LE, and 8 patients needed PA augmentation for PABS in C. The median velocity of right/left PA was measured as 1.6/1.9 m/s in LE and 2.1/2.3 m/s in C, so it showed a lower value in LE. CONCLUSIONS Excellent mid-term results were obtained with the LE method. It was considered a useful procedure in preventing PABS, which is a primary late complication of ASO. Further follow-up and investigations are needed.

scholarly journals Primary Arterial Switch Operation for TGA/IVS and Regressed Left Ventricle: How and When to Use Left Ventricular Assist Device

2019 ◽  
Vol 11 (1) ◽  
pp. 97-100
Author(s):  
Dhananjay P. Malankar ◽  
Sachin Patil ◽  
Shivaji Mali ◽  
Shyam Dhake ◽  
Amit Mhatre ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Arterial Switch Operation ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Arterial Switch ◽  
Switch Operation ◽  
Left Ventricular Assist

Purpose: Numerous attempts have been made to extend the boundaries of arterial switch operation (ASO) in children presenting late with transposition of great arteries with intact ventricular septum (TGA/IVS) and regressed left ventricle (rLV). Many children tolerate the delayed ASO uneventfully, whereas others need mechanical circulatory support (MCS) to sustain the systemic circulation while the left ventricle undergoes retraining. Description: In this article, we describe six consecutive children with TGA/IVS and rLV who underwent primary ASO. Results: Three were managed medically, while three required MCS in the form of Centrimag left ventricular assist device (LVAD). All patients survived the operation and were discharged home in a stable condition. Conclusions: Primary ASO can be safely performed in children with TGA/IVS and rLV, provided the center has MCS options. Supporting the rLV with LVAD is feasible and can be achieved safely.

Extending the limits of the primary arterial switch operation for TGA

2006 ◽  
Vol 22 (1) ◽  
pp. 47-47
Author(s):  
P Krishnan ◽  
SK Pranav ◽  
K Sivakumar ◽  
J Shahani ◽  
M Srinivias
Keyword(s):  
Arterial Switch Operation ◽  
Arterial Switch ◽  
Switch Operation
Sign in / Sign up

Export Citation Format

Share Document