Chu Y L
Xinqiao Hospital, Third Military Medical College, Chongqing.
Zhonghua Wai Ke Za Zhi. 1992 May;30(5):301-2, 318.
From Nov. 1976 to Dec. 1989, 9 patients with congenital coronary artery-cardial chamber fistula were operated upon in our hospital. In this series right coronary artery-right ventricle fistula was found in 3 patients, right coronary artery-left ventricle fistula in 2, left coronary artery-right ventricle fistula in 2, left circumflex artery-right atrium fistula in 1, and bilateral coronary artery-cardiac chamber fistula in 1. Cardiopulmonary bypass was performed in 8. The fistula was closed by interrupted mattress sutures outside the cardiac chamber plus ligation of terminal portion of the coronary artery near the fistula in 5 patients, and by mattress sutures inside the dilated coronary artery or cardiac chamber in other 4. There was no operative death in the 8 patients with single fistula. One patient with bilateral coronary artery fistula died from hypoxemia postoperatively. Late complications or recurrent fistulas were not found in the follow-up period from 3 months to 12 years. The diagnosis, operative indications and technique of closing fistula were discussed.
1976年11月至1989年12月,我院对9例先天性冠状动脉-心腔瘘患者进行了手术治疗。本组中,3例为右冠状动脉-右心室瘘,2例为右冠状动脉-左心室瘘,2例为左冠状动脉-右心室瘘,1例为左旋支动脉-右心房瘘,1例为双侧冠状动脉-心腔瘘。8例患者进行了体外循环。5例患者通过在心脏腔外间断褥式缝合加结扎瘘口附近冠状动脉末端来关闭瘘口,另外4例通过在扩张的冠状动脉或心脏腔内褥式缝合来关闭瘘口。8例单瘘患者无手术死亡。1例双侧冠状动脉瘘患者术后死于低氧血症。在3个月至12年的随访期内未发现晚期并发症或复发性瘘。讨论了诊断、手术适应证及关闭瘘口的技术。