Wong H I, Su W J, Chang C H
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1989 Mar-Apr;30(2):134-9.
The records of 5 patients with congenital coronary arteriovenous fistula, diagnosed by echocardiogram, cardiac catheterization, angiocardiography and confirmed by cardiac surgery between 1982 and 1988, were studied. Their ages ranged from 3 months to 13 years. Among them, 3 were asymptomatic; one developed congestive heart failure shortly after birth, and was treated with digoxin and furosemide. Another patient had exertional dyspnea and fatigue. A grade 3-4/6 continuous murmur was heard over the right or left lower sternal border in four patients; only a pansystolic murmur was heard over the left lower sternal border in the remaining one patient. All the five patients had right coronary arteriovenous fistula terminating into the right ventricle. All received cardiac surgery. Direct epicardial ligation of the fistula was performed in one patient. The rest four cases required cardiopulmonary bypass and suture closure through the right ventricle by direct suture of the orifice in one patient, and Dacron patch closure in other three patients. No postoperative complications occurred in all patients. In conclusion, since the operation was quite safe, if patient had significant shunts and/or clinical symptoms, surgical correction should be considered.
对1982年至1988年间经超声心动图、心导管检查、心血管造影诊断并经心脏手术证实的5例先天性冠状动脉瘘患者的病历进行了研究。他们的年龄从3个月到13岁不等。其中，3例无症状；1例出生后不久出现充血性心力衰竭，接受了地高辛和速尿治疗。另1例患者有劳力性呼吸困难和疲劳症状。4例患者在胸骨右缘或左缘下部可闻及3 - 4/6级连续性杂音；其余1例患者仅在胸骨左缘下部闻及全收缩期杂音。所有5例患者均为右冠状动脉瘘，瘘口均通向右心室。所有患者均接受了心脏手术。1例患者进行了瘘管的心外膜直接结扎。其余4例患者需要体外循环，其中1例通过直接缝合瘘口经右心室缝合关闭，另外3例患者使用涤纶补片关闭。所有患者均未发生术后并发症。总之，由于手术相当安全，如果患者有明显分流和/或临床症状，应考虑手术矫正。
