Komoda Satsuki, Komoda Takeshi, Ivanitskaia-Kuehn Ekaterina, Dreysse Stephan, Pasic Miralem, Hetzer Roland
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
Gen Thorac Cardiovasc Surg. 2010 Feb;58(2):78-81. doi: 10.1007/s11748-009-0453-x. Epub 2010 Feb 13.
We describe the case of a 67-year-old man with a rare combination of a giant coronary artery aneurysm with a fistula draining into the coronary sinus. The patient presented with a sensation of retrosternal pressure. He was examined by coronary angiography, which revealed a large aneurysm of the right coronary artery (RCA) with a fistula. This fistula originated from the distal RCA shortly beyond the crux and drained into the coronary sinus. The aneurysm was in the proximal portion of the RCA, measuring 4 cm in diameter and 7 cm in length. Surgical repair by closure of the fistula under direct vision, suture closure and plication of the aneurysm, and coronary artery bypass was performed. Postoperative echocardiography and computed tomography confirmed closure of the fistula. The patient remains symptom-free at 4 months after surgery.
我们描述了一例67岁男性患者，其患有巨大冠状动脉瘤并伴有瘘管引流至冠状窦这一罕见组合情况。患者表现为胸骨后压迫感。通过冠状动脉造影对其进行检查，结果显示右冠状动脉（RCA）存在一个伴有瘘管的大动脉瘤。该瘘管起源于RCA在十字交叉处稍远的远端，并引流至冠状窦。动脉瘤位于RCA的近端部分，直径为4厘米，长度为7厘米。通过在直视下封闭瘘管、缝合封闭并折叠动脉瘤以及进行冠状动脉搭桥术来实施手术修复。术后超声心动图和计算机断层扫描证实瘘管已封闭。患者术后4个月仍无症状。
