Liang Chi-D, Ko Sheung F
Department of Pediatric Cardiology, Chang Gung Children's Hospital, Chang Gung University, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung County 833, Taiwan.
Pediatr Cardiol. 2006 Sep-Oct;27(5):557-63. doi: 10.1007/s00246-006-1317-0. Epub 2006 Aug 30.
The mid- to long-term outcome of pediatric patients with coronary artery fistula (CAF) after transcatheter closure remains unknown. This study reports the midterm outcome of CAF closure by transcatheter Gianturco coil occlusion in pediatric patients. Eighteen patients with CAF confirmed by coronary angiography were seen in our institution. Among them, 4 patients who had persistent coronary artery dilatation received transcatheter Gianturco coil occlusion (age range, 25 months to 12 years; mean, 4.6 years). Two were closed with a single coil, and two were closed with two coils. No residual shunts were detected on follow-up angiography and echocardiography immediately after coil occlusion in all cases. Follow-up Doppler echocardiography (4/4) and angiography (3/4) showed persistent CAF occlusion in all 4 patients. Two of 3 patients with coexistent aneurysmal formation showed obliteration of the aneurysm on angiographic follow-up. In addition, 2 showed resumption of normal coronary arterial size, and 2 showed decrement of the coronary arterial diameter. All 4 patients had normal ECG findings after 26-83 months (mean, 49 months) of follow-up, and all were in NYHA functional class I. The midterm outcome of percutaneous transcatheter coil occlusion in the treatment of CAF is excellent.
小儿冠状动脉瘘（CAF）经导管封堵术后的中长期预后尚不清楚。本研究报告了小儿患者经导管用 Gianturco 弹簧圈封堵 CAF 的中期预后。我院共诊治 18 例经冠状动脉造影确诊为 CAF 的患者。其中，4 例存在持续性冠状动脉扩张的患者接受了经导管 Gianturco 弹簧圈封堵术（年龄范围为 25 个月至 12 岁；平均 4.6 岁）。2 例用单个弹簧圈封堵，2 例用两个弹簧圈封堵。所有病例在弹簧圈封堵后立即进行的随访血管造影和超声心动图检查均未发现残余分流。随访的多普勒超声心动图（4/4）和血管造影（3/4）显示所有 4 例患者的 CAF 持续封堵。3 例合并动脉瘤形成的患者中，2 例在血管造影随访时动脉瘤消失。此外，2 例冠状动脉大小恢复正常，2 例冠状动脉直径减小。所有 4 例患者在随访 26 - 83 个月（平均 49 个月）后心电图结果均正常，且均为纽约心脏协会（NYHA）心功能 I 级。经皮经导管弹簧圈封堵治疗 CAF 的中期预后良好。
