Terasaki Takamitsu, Takano Tamaki, Tanaka Haruki
Department of Cardiovascular Surgery, Shunshu University School of Medicine, Matsumoto, Japan.
Thorac Cardiovasc Surg Rep. 2014 Dec;3(1):31-2. doi: 10.1055/s-0034-1387823. Epub 2014 Aug 19.
Two years previously, a 73-year-old man with mitral regurgitation underwent mitral annuloplasty and left atrial appendage (LAA) exclusion by suturing the orifice from the endocardium. However, the mitral regurgitation became exacerbated, and the left atrium enlarged rapidly over a 6-month period. Computed tomography showed a heterogenic mass in the LAA, and coronary angiography revealed a coronary artery-LAA fistula. Reoperation revealed a thrombus filling the appendage and two small orifices of the coronary artery-LAA fistula located in the endocardium of the appendage. We excised the LAA and closed these fistula orifices concomitant with mitral valve replacement.
两年前，一名患有二尖瓣反流的73岁男性接受了二尖瓣环成形术，并通过从心内膜缝合开口对左心耳（LAA）进行了封堵。然而，二尖瓣反流加重，左心房在6个月内迅速增大。计算机断层扫描显示左心耳内有一个异质性肿块，冠状动脉造影显示存在冠状动脉-左心耳瘘。再次手术发现血栓填充了心耳，冠状动脉-左心耳瘘的两个小孔位于心耳的心内膜。我们切除了左心耳，并在进行二尖瓣置换的同时封闭了这些瘘口。
