Mukae Yosuke, Kawasaki Hiromitsu, Sato Manabu, Nakayama Yoshihiro
The Department of Cardiovascular Surgery of Osumikanoya Hospital, Kanoya, Japan.
Kyobu Geka. 2014 Aug;67(9):853-5.
Bilateral coronary-pulmonary artery fistulas are very rare. We report a case of a 68-year-old woman without any previous medical history, who presented to our hospital after slow onset of chest heaviness on exertion. Coronary computed tomography (CT) and angiography revealed 2 fistulas:one arising from the left anterior descending artery accompanied by an aneurysm and the other from the right coronary artery. We opened the trunk of the pulmonary artery under cardio-pulmonary bypass and cardiac arrest. We recognized the outflow of the shunt just above the right pulmonary cusp, which was closed from the outside. We also closed the aneurysm of the shunt. Neither the fistulas nor the aneurysm was recognized by postoperative CT. The chest symptom disappeared.
双侧冠状动脉-肺动脉瘘非常罕见。我们报告一例68岁女性,既往无任何病史,因劳力性胸部沉重感起病缓慢后来我院就诊。冠状动脉计算机断层扫描(CT)及血管造影显示有2处瘘管:一处起自左前降支并伴有一个动脉瘤,另一处起自右冠状动脉。我们在体外循环和心脏停搏下打开肺动脉主干。我们在右肺动脉瓣上方识别出分流的流出道,从外部将其封闭。我们还封闭了分流处的动脉瘤。术后CT未发现瘘管及动脉瘤。胸部症状消失。