Sekine Y, Kitano M, Akimoto T, Matsuda K
Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan.
Kyobu Geka. 2007 Dec;60(13):1137-41.
Coronary artery fistulae are relatively rare congenital anomalies. Those associated with saccular coronary artery aneurysms are even rarer. Including the current case, only 65 such cases have been reported in Japan. A 62-year-old female was admitted to our hospital for evaluation of abnormal shadow on the chest X-ray. The enhanced chest computed tomography (CT) scan demonstrated a giant saccular coronary aneurysm on the left side of the pulmonary artery. Multi-detector row CT (MDCT) scan demonstrated the coronary artery aneurysm was connected to the left anterior descending artery. Coronary angiography revealed 2 aneurysms with bilateral coronary artery to pulmonary artery fistulae. The patient underwent aneurysmectomy and ligation of fistulae under cardiopulomonary bypass. The postoperative course was uneventful and postoperative coronary angiography revealed complete resection of the aneurysms and only slight blood flow through the fistulae. She was discharged on the 10th postoperative day.
冠状动脉瘘是相对罕见的先天性异常。那些与囊状冠状动脉瘤相关的情况更为罕见。包括当前病例在内，日本仅报道过65例此类病例。一名62岁女性因胸部X线检查发现异常阴影入住我院。胸部增强计算机断层扫描（CT）显示肺动脉左侧有一个巨大的囊状冠状动脉瘤。多排探测器CT（MDCT）扫描显示冠状动脉瘤与左前降支相连。冠状动脉造影显示有2个动脉瘤伴有双侧冠状动脉至肺动脉瘘。患者在体外循环下接受了动脉瘤切除术和瘘管结扎术。术后过程顺利，术后冠状动脉造影显示动脉瘤已完全切除，瘘管仅有轻微血流。她于术后第10天出院。
