Lebreiro Ana, Pinho Teresa, Silva João Carlos, Madureira António, Macedo Filipe, Ramos Isabel, Maciel Maria Júlia
Serviço de Cardiologia, Hospital de São João, Porto, Portugal.
Rev Port Cardiol. 2010 Mar;29(3):433-7.
Coronary artery fistulas are rare coronary anomalies; coronary angiography remains the gold standard for the diagnosis, and is essential to plan either surgical or percutaneous intervention. The use of an Amplatzer Vascular Plug device in percutaneous closure of coronary fistulas has been recently described in a few cases of paediatric age patients, with positive results, but has never been reported in adult patients. We report the case of a 36-year-old female, with an unusually large right coronary artery fistula draining into superior vena cava that was successfully closed percutaneously, using a 14 mm Amplatzer device (Vascular Plug II, AGA). We also discuss our therapeutic option, since management of large, asymptomatic fistulas, is still a matter of debate, although most authors tend to recommend its closure.
冠状动脉瘘是一种罕见的冠状动脉异常；冠状动脉造影仍是诊断的金标准，对于规划手术或经皮介入治疗至关重要。最近在少数儿科患者中描述了使用Amplatzer血管封堵器经皮闭合冠状动脉瘘，结果良好，但在成年患者中从未有过报道。我们报告了一例36岁女性患者，其右冠状动脉瘘异常粗大，引流至上腔静脉，使用14毫米Amplatzer装置（血管封堵器II型，AGA）成功经皮闭合。我们还讨论了我们的治疗选择，因为对于大型无症状瘘的处理仍存在争议，尽管大多数作者倾向于建议予以闭合。
