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CT coronary angiogram in children with Kawasaki patients: experience in 52 patients

Published online by Cambridge University Press:  16 June 2022

Boekhren K. Borhanuddin Open the ORCID record for Boekhren K. Borhanuddin [Opens in a new window] ,
Haifa Abdul Latiff Open the ORCID record for Haifa Abdul Latiff [Opens in a new window]  and
Ahmad K. Mohamed Yusof
Boekhren K. Borhanuddin*
Affiliation:
Department of Pediatric Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia
Haifa Abdul Latiff
Affiliation:
Department of Pediatric Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia
Ahmad K. Mohamed Yusof
Affiliation:
Department of Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia
*
Author for correspondence: B. K. Borhanuddin, MD, M Med, Department of Pediatric Cardiology, Insitut Jantung Negara, 146, Jalan Tun Razak, 50400, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia. Tel: +603 2617 8200; Fax: +60326178973. E-mail: dr.boekhren@ijn.com.my
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Abstract

Background:

CT is an accepted non-invasive imaging tool to assess the coronary arteries in adults; however, its utilisation in children is limited by high heart rate and lack of standardised protocol. We sought to assess diagnostic quality and factors that affect image quality of CT in assessing coronary artery lesions in Kawasaki patients less than 18 years of age.

Methodology:

CT coronary angiography was performed on patients with Kawasaki disease diagnosed with coronary aneurysm or suspected to have coronary stenosis. Studies were performed using electrocardiogram-gated protocols. General anaesthesia was used in patients who were not cooperative for breathing control. Heart rate, image quality, and effective radiation dose were documented.

Results:

Fifty-two Kawasaki patients underwent CT coronary angiography to assess coronary artery lesions. Median heart rate was 88 beats per minute (range 50–165 beats/minute). Image quality was graded as excellent in 34 (65%) patients, good in 17 (32%), satisfactory in 1, and poor in 1 patient. Coronary artery aneurysm was found in 25 (bilateral = 6, unilateral = 19, multiple = 11). Thrombus was found in 11 patients resulting in partial and total occlusion in 8 and 3 patients, respectively. Coronary stenosis was noted in 2 patients. The effective radiation dose was 1.296 millisievert (median 0.81 millisievert). Better diagnostic imaging quality was significantly related to lower heart rate (p = 0.007).

Conclusion:

Electrocardiogram-triggered CT coronary angiography provides a good diagnostic assessment of coronary artery lesions in children with Kawasaki disease.

Keywords

Experience CT coronary Kawasaki
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 12 , December 2022 , pp. 1994 - 1998
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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