Pezzella A Thomas, Falaschi Giorgio, Ott David A., Cooley Denton A.
Department of Cardiovascular Surgery of the Texas Heart Institute, Houston, Texas.
Cardiovasc Dis. 1981 Sep;8(3):355-363.
Of 59 patients who underwent operative correction of congenital coronary artery fistulas from May 1956 through May 1980 at our institution, three had fistulas that arose from the coronary artery and terminated in the left heart. The chief indication for surgical correction in such patients is the presence of symptoms or the development of complications, which include rupture, endocarditis, and congestive heart failure. The principal objective of repair is closure or obliteration of the fistulous communication and preservation of distal myocardial perfusion. Because symptoms and complications tend to occur with age, elective ligation is warranted during childhood, even in asymptomatic patients. The three cases described here, as well as the reviewed series of left heart fistulas, substantiate this fact. All three patients were symptomatic before operation and asymptomatic afterward.
1956年5月至1980年5月在我们机构接受先天性冠状动脉瘘手术矫正的59例患者中，有3例瘘管起源于冠状动脉并终止于左心。此类患者手术矫正的主要指征是出现症状或发生并发症，并发症包括破裂、心内膜炎和充血性心力衰竭。修复的主要目的是闭合或消除瘘管交通并保留远端心肌灌注。由于症状和并发症往往随年龄增长而出现，因此即使是无症状患者，也有必要在儿童期进行择期结扎。本文所述的3例病例以及回顾的左心瘘管系列病例证实了这一事实。所有3例患者术前均有症状，术后无症状。
