Cetin Gürkan, Saltik Levent, Ozkara Ahmet, Babaoğlu Kadir
Department of Cardiovascular Surgery, Institute of Cardiology, Istanbul University, Istanbul, Turkey.
Eur J Cardiothorac Surg. 2005 Mar;27(3):518-9. doi: 10.1016/j.ejcts.2004.12.027. Epub 2005 Jan 13.
Ischemic changes and acute or subacute cardiac failure after arterial switch operation generally results from imperfect transfer of coronary arteries to the neoaorta. Peroperative and early postoperative myocardial ischemia is the main cause of death in these patients. We present an unusual cause of myocardial ischemia and cardiac failure after arterial switch: a congenital coronary artery fistula between the circumflex artery and the right ventricle. The symptoms imitate coronary translocation failure. In differential diagnosis of the coronary perfusion problems encountered after the arterial switch operation, coronary artery fistula should not be forgotten, although it is rare.
动脉调转手术后的缺血性改变以及急慢性心力衰竭通常是由于冠状动脉向新主动脉的转移不完善所致。围手术期和术后早期心肌缺血是这些患者死亡的主要原因。我们报告了一例动脉调转术后心肌缺血和心力衰竭的罕见病因：左旋支动脉与右心室之间的先天性冠状动脉瘘。其症状类似冠状动脉移位失败。在动脉调转手术后出现的冠状动脉灌注问题的鉴别诊断中，尽管冠状动脉瘘很罕见，但不应被忽视。
