Kassaian Seyed Ebrahim, Mahmoodian Mehran, Salarifar Mojtaba, Alidoosti Mohammad, Abbasi Seyed Hesameddin, Rasekh Abdi
Department of Cardiology, Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran.
Tex Heart Inst J. 2007;34(2):199-202.
Coronary artery fistulae may be congenital or acquired abnormalities in which blood is shunted into a cardiac chamber, great vessel, or other structure, bypassing the myocardial capillary network. Patients with coronary artery fistulae may present with dyspnea, congestive heart failure, angina, endocarditis, arrhythmias, or myocardial infarction. Symptomatic patients must be treated in order to prevent such complications as sudden death or myocardial infarction. Surgery is the gold standard for closure of these lesions; however, an increasing number of reports have shown that percutaneous closure may be a safe and effective alternative. We report the successful percutaneous exclusion of multiple coronary artery-to-pulmonary artery fistulae by means of several balloon-expandable stent-grafts in a patient who had a history of coronary artery bypass surgery and symptoms of congestive heart failure.
冠状动脉瘘可能是先天性或后天性异常，其中血液分流至心腔、大血管或其他结构，绕过心肌毛细血管网。冠状动脉瘘患者可能出现呼吸困难、充血性心力衰竭、心绞痛、心内膜炎、心律失常或心肌梗死。有症状的患者必须接受治疗以预防猝死或心肌梗死等并发症。手术是闭合这些病变的金标准；然而，越来越多的报告表明，经皮闭合可能是一种安全有效的替代方法。我们报告了一例有冠状动脉搭桥手术史且有充血性心力衰竭症状的患者，通过多个球囊扩张式覆膜支架成功经皮封堵多处冠状动脉至肺动脉瘘。
