Somers J M, Verney G I
Department of Diagnostic Radiology, Papworth Hospital, Cambridge.
Clin Radiol. 1991 Dec;44(6):419-21. doi: 10.1016/s0009-9260(05)80664-6.
Coronary cameral fistulae in 208 orthotopic heart transplants performed at Papworth Hospital were examined. Sixteen fistulae in 208 heart transplants were identified (7.7%). This compares with a reported incidence of 0.2% or less in native hearts. Seven (3.4%) were similar to previously described fistulae to the right ventricle and were secondary to endomyocardial biopsy. Four (1.9%) arose from right or left coronary artery atrial branches and drained into the right atrium. We have called these 'suture line fistulae'. Five (2.4%) arose from left coronary branches at the apex; four of these drained into the left ventricle and one into the right ventricle. We believe these to be secondary to cutting needle biopsy of the apex of the donor heart before transplant and have designated them 'harvest biopsy fistulae'. One patient with a large fistula angiographically had no oximetric evidence of shunt at cardiac catheterization. Coronary cameral fistulae are an uncommon complication of heart transplantation and follow-up biopsy, and appear to be of no haemodynamic significance.
对在帕普沃思医院进行的208例原位心脏移植中的冠状动脉心腔瘘进行了检查。在208例心脏移植中发现了16例瘘管（7.7%）。这与报道的天然心脏中0.2%或更低的发病率相比。7例（3.4%）与先前描述的右心室瘘管相似，继发于心内膜活检。4例（1.9%）起源于右或左冠状动脉心房分支并引流至右心房。我们将这些称为“缝线瘘管”。5例（2.4%）起源于心尖部的左冠状动脉分支；其中4例引流至左心室，1例引流至右心室。我们认为这些继发于移植前供体心脏心尖部的切割针活检，并将其命名为“获取活检瘘管”。1例经血管造影显示有大瘘管的患者在心脏导管检查时没有分流的血氧测定证据。冠状动脉心腔瘘是心脏移植和随访活检的罕见并发症，似乎没有血流动力学意义。
