To assess the incidence of the coronary abnormalities and their outcome, angiographic evaluations were performed at the Department of Pediatrics, Kyushu University Hospital, from January 1973 to December 1994, on 313 children (189 boys and 124 girls) after Kawasaki disease (KD). The age at onset of KD and the interval from the onset to the first angiographic evaluation ranged from 0.2 to 12.3 years [2.2 +/- 2.0 years (mean +/- S.D.)] and from 0.1 to 15.3 years [2.4 +/- 3.0 years], respectively. Seventy-six of the 313 (24.3%) children studied had the coronary abnormalities as the sequelae of KD. Forty had left coronary lesions alone, 10 right coronary lesions alone, and 26 both coronary lesions. Serial angiographic evaluation elucidated the difference of the fate of right and left coronary lesions. Left coronary aneurysms tended to regress gradually and to develop stenotic lesions. Complete occlusion of the left coronary arterial lesion was confirmed in only 2 of 66 patients (3.0%). Right coronary aneurysms, on the other hand, regressed relatively early in the subchronic phase and complete occlusion or segmental stenosis was present in 9 of 36 patients with the rate (25%) being higher than the left. The interval from the onset to the recognition of occlusion or segmental stenosis ranged from 0.5 to 7.7 years (median 4.0 years). In 8 of 9 patients with right coronary artery occlusion, left coronary arterial lesions were also present. In spite of severe sequelae, children or young adolescents with cardiovascular system-related symptoms were unexpectedly rare.(ABSTRACT TRUNCATED AT 250 WORDS)