Lawrie G M, Morris G C, Winters W L
Ann Thorac Surg. 1976 Jul;22(1):87-90. doi: 10.1016/s0003-4975(10)63958-6.
The fate of aortocoronary saphenous vein bypass graft to the left anterior descending (LAD) coronary vein is reported. The vein graft communicated with the coronary sinus through the proximal LAD vein, producing a functional coronary arteriovenous fistula. The LAD vein was totally occluded distally at follow-up four months after operation. The natural history of congenital fistulas between coronary arteries and the coronary sinus suggested that bacterial endocarditis, pulmonary hypertension, and cardiac failure were all possible future complications in this patient. Operation was performed to revascularize the LAD artery to relieve persistent angina, and to close the fistula. Postoperative angiography showed a patent graft to the LAD artery with complete obliteration of the fistula. The patient is asymptomatic ten months after operation.
报告了左前降支（LAD）冠状动脉的主动脉冠状动脉大隐静脉旁路移植的转归。静脉移植物通过近端LAD静脉与冠状窦相通，形成功能性冠状动脉动静脉瘘。术后4个月随访时，LAD静脉远端完全闭塞。冠状动脉与冠状窦之间先天性瘘的自然病史提示，该患者未来可能出现细菌性心内膜炎、肺动脉高压和心力衰竭等并发症。为使LAD动脉血运重建以缓解持续性心绞痛并闭合瘘管而进行了手术。术后血管造影显示LAD动脉移植物通畅，瘘管完全闭塞。患者术后10个月无症状。
