López-Candales Angel, Kumar Vivek
Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Cardiovasc Ultrasound. 2005 Nov 8;3:35. doi: 10.1186/1476-7120-3-35.
Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle.
We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow.
The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.
冠状动脉心腔瘘是一种罕见的病症，其病因可能是先天性的或创伤性的。它们涉及冠状动脉（通常是右冠状动脉）异常终止于心脏腔室（通常是右心室）。
我们描述了一例患有严重主动脉瓣狭窄和室间隔肥厚的女性患者，该患者接受了生物人工主动脉瓣置换术并同时进行了室间隔心肌切除术。在随后的随访中，发现有异常血流穿过室间隔进入左心室，多普勒检查显示为连续性血流，主要为舒张期成分，与冠状动脉血流一致。
对冠状动脉心腔瘘的文献进行了综述，并讨论了诊断结果的病因。在我们的患者中，冠状动脉至左心室瘘最有可能是由于心肌切除术中间隔穿支动脉受到创伤所致。由于患者在诊断时无症状，因此未建议进行干预，且随访情况良好。
