Schleich J M, Rey C, Gewillig M, Bozio A
Service des Maladies Cardiovasculaires Infantiles et Congénitales, Centre Hospitalier Universitaire, Lille, France.
Heart. 2001 Apr;85(4):E6. doi: 10.1136/heart.85.4.e6.
Six cases of full spontaneous closure of congenital coronary artery fistulas, and one case of near closure, as seen by colour Doppler echocardiography, are presented. It is worth reconsidering the classical view that nearly all cases of spontaneous closure are eligible for surgical or percutaneous correction to prevent the development of significant and potentially fatal complications. As the natural course of coronary artery fistulas is still poorly defined, asymptomatic patients, especially those under 7 years old with small shunts, should be periodically followed up by echocardiography rather than be subjected to operative closure, even by catheterisation.
本文报道了6例先天性冠状动脉瘘完全自然闭合及1例近乎闭合的病例，这些均由彩色多普勒超声心动图所见。几乎所有自然闭合病例都适合手术或经皮矫正以预防严重且可能致命并发症的发生，这种传统观点值得重新审视。由于冠状动脉瘘的自然病程仍不明确，无症状患者，尤其是7岁以下小分流患者，应通过超声心动图定期随访，而非接受手术闭合，即使是导管介入手术。
