Cozzi G, Gordini V, Filomeni D, Pellegrini A
G Ital Cardiol. 1976;6(7):1194-200.
The authors report of their own experience of 6 patients suffering from congenital coronary fistula. In 3 cases the fistula originated from the right coronary artery and in the other 3, from the branches of the left coronary artery. In 2 cases the fistula ended in the right atrium and in 4 cases in the right ventricle. Three patients were asymptomatic, 2 with cardiac insufficiency and 1 suffering from angor. We normally recommend surgical operation for the symptomatic patients, and for the asymptomatic, whenever there is a considerable shunt sin/dx and/or for important electrocardiogram alteration. All of the patients was operated on, 4 of them by means of extracorporeal circulation. In 3 of them a straight ligation of the fistula was carried out: in one, ligation of the fistula associated with the removal of a myocardial aneurysm, in one the suture of the intima of the fistula after arteriotomy, and in one the suture after right atriotomy. There were no complications immediately after the surgical operation. Five of our patients were checked from 3 to 7 years after the operation. All of them showed a normal radiological picture and disappearance of electrocardiogram evidence of pre-existing myocardial ischemia.
作者报告了他们治疗6例先天性冠状动脉瘘患者的自身经验。其中3例瘘管起源于右冠状动脉，另外3例起源于左冠状动脉分支。2例瘘管终止于右心房，4例终止于右心室。3例患者无症状，2例有心脏功能不全，1例有心绞痛。我们通常建议对有症状的患者进行手术，对于无症状的患者，只要存在明显的分流和/或有重要的心电图改变，也建议手术。所有患者均接受了手术，其中4例通过体外循环进行。3例直接结扎瘘管：1例在结扎瘘管的同时切除心肌动脉瘤，1例在动脉切开术后缝合瘘管内膜，1例在右心房切开术后缝合。手术后立即没有并发症。我们的5例患者在术后3至7年接受了检查。他们所有人的放射学检查结果均正常，术前存在的心肌缺血的心电图证据消失。
