Department of Cardiology, ZGT location Hengelo, Geerdinksweg 141, 7555 DL, Hengelo, the Netherlands,
Neth Heart J. 2011 Apr;19(4):183-91. doi: 10.1007/s12471-011-0088-2.
Coronary artery fistulas (CAFs) are infrequent anomalies, coincidentally detected during coronary angiography (CAG).
To elucidate the currently used diagnostic imaging modalities and applied therapeutic approaches.
Five Dutch patients were found to have CAFs. A total of 170 reviewed subjects were subdivided into two comparable groups of 85 each, treated with either percutaneous 'therapeutic' embolisation (PTE group) or surgical ligation (SL group).
In our series, the fistulas were visualised with several diagnostic imaging tests using echocardiography, multidetector computed tomography, and CAG. Four fistulas were unilateral and one was bilateral; five originated from the left and one originated from the right coronary artery. Among the reviewed subjects, high success rates were found in both treatment groups (SL: 97% and PTE: 93%). Associated congenital or acquired cardiovascular disorders were frequently present in the SL group (23%). Bilateral fistulas were present in 11% of the SL group versus 1% of the PTE group. The fistula was ligated surgically in one and abolished percutaneously in another. Medical treatment including metoprolol was conducted in two, and watchful waiting follow-up was performed in one.
Several diagnostic imaging techniques are available for assessment of the anatomical and functional characteristics of CAFs.
冠状动脉瘘（CAF）是一种罕见的异常情况，通常在冠状动脉造影（CAG）时偶然发现。
阐明目前使用的诊断成像方式和应用的治疗方法。
发现荷兰的 5 名患者存在 CAF。共对 170 名接受回顾性分析的患者进行分组，每组 85 人，分别接受经皮“治疗性”栓塞（PTE 组）或手术结扎（SL 组）治疗。
在我们的系列中，使用超声心动图、多排螺旋 CT 和 CAG 等多种诊断成像测试观察到瘘管。4 个瘘管为单侧，1 个为双侧；5 个起源于左冠状动脉，1 个起源于右冠状动脉。在接受回顾性分析的患者中，两组的治疗成功率均较高（SL 组：97%，PTE 组：93%）。在 SL 组中，经常存在与先天性或获得性心血管疾病相关的并发症（23%）。SL 组中有 11%存在双侧瘘管，而 PTE 组中仅有 1%。1 个瘘管通过手术结扎，另 1 个通过经皮栓塞消除。2 人接受了包括美托洛尔在内的药物治疗，1 人进行了密切观察等待随访。
有多种诊断成像技术可用于评估 CAF 的解剖和功能特征。
