Huhn G, Fassbender D, Gleichmann U
Herzzentrum Nordrhein-Westfalen, Kardiologische Klinik.
Z Kardiol. 1989 Jul;78(7):435-40.
Between 1976 and 1988, we found in a series of 18,000 coronary angiographies, 12 cases with 15 arteriovenous fistulas of the coronary vessels (incidence of 0.7%). Clinical symptoms were atypical angina pectoris and dyspnea upon exertion. Three patients had a systolic-diastolic murmur. In six cases we found fistulas accidentally, in concurrence with another important cardiovascular disease; 10 fistulas were singular, two fistulas were bilateral. The course was in 10 cases to the pulmonary artery, in three cases to the right atrium, in one case to the right ventricle, and in one case to the superior vena cava. With the exception of one patient, shunt volume was minimal. There were two preoperative sudden deaths of patients with extended fistulas and supra-ventricular arrhythmias. Complications and delineations of management are discussed.
在1976年至1988年期间，我们在一系列18000例冠状动脉造影中发现了12例患者存在15处冠状动脉动静脉瘘（发生率为0.7%）。临床症状为不典型心绞痛和劳力性呼吸困难。3例患者有收缩期-舒张期杂音。6例是在偶然情况下发现瘘管的，同时伴有另一种重要的心血管疾病；10处瘘管为单发，2处瘘管为双侧。瘘管走向：10例通向肺动脉，3例通向右心房，1例通向右心室，1例通向头臂静脉。除1例患者外，分流量极小。有2例术前因广泛瘘管和室上性心律失常突然死亡。文中讨论了并发症及处理方法。
