Orthotopic heart transplant for treatment-resistant cardiomyopathy in Kawasaki syndrome: report of a successful case.

Kawasaki disease is a systemic vascular inflammatory disorder of yet unknown cause that is associated with critical cardiovascular complications. Several long-term medical therapies, coronary revascularization, and heart transplant have been introduced to treat coronary artery lesions. This report describes a 20-year-old man with Kawasaki disease manifesting as intermittent chest pain and nausea who had advanced decompensated cardiomyopathy (ejection fraction, 15%) diagnosed. Coronary artery bypass surgery and implantation of a cardioverter defibrillator had been performed, although no significant clinical improvement was observed. Finally, a successful orthotopic bicaval heart transplant was performed. Follow-up examination after 1 year revealed normal cardiac function with no evidence of organ rejection. This experience demonstrated that heart transplant might be a successful method of treating permanent ischemic cardiomyopathy in patients with Kawasaki syndrome.