We reported an 8 year-old-girl who has been implanted a 3x15 mm covered stent in the mid right coronary artery (RCA) aneurysm. She has been diagnosed as a Kawasaki disease in 2001 without immunoglobulin therapy. Early echocardiographic follow up showed multiple aneurysms at proximal left main coronary artery (LMCA), left anterior descending (LAD) and RCA with the diameters of 5.4, 8.5, and 5 mm respectively. During follow up, though aneurysms have not regressed, she has been doing well with an intact left ventricular systolic function. She has been commencing with low dose aspirin and oral warfarin during follow up. Last coronary angiography, March 2008, showed a significant stenosis (>90%) of proximal and distal part of a huge mid RCA aneurysm. There was no scar or infarction on cardiac MRI study.
Covered stent has been implanted in April 2008 with a favorable outcome. The mid RCA aneurysm has been obliterated and excellent distal RCA flow has been achieved. She has been anticoagulated with oral warfarin (INR > 2) and low dose aspirin after the treatment. However, significant in-stent restenosis has demonstrated 6 months later requiring another 3x23 mm drug eluting stent placement over the previous one.
Though coronary intervention using covered stent has been feasible, in-stent restenosis has occurred quite early after the treatment.