Watanabe Y, Ohteki H, Minato N, Sakurai J, Natsuaki M, Itoh T
Nihon Kyobu Geka Gakkai Zasshi. 1989 Jun;37(6):1206-10.
A surgical case of left coronary artery-pulmonary artery fistula with giant saccular aneurysm was reported. The aneurysm was successfully resected under total extra-corporeal circulation. The patient was 67-year-old female who was admitted for evaluation of chest pain and heart murmur. On coronary angiography, the diagnosis was made as a coronary artery fistula originating from the left anterior descending artery and draining into the pulmonary artery. The operation was indicated by the fact that the combination with giant saccular aneurysm and positive findings of ischemic changes on exercise electrocardiogram. Intraoperative flowmetry on the fistula revealed that estimated average flow was 200 ml/min and the coronary steal phenomenon was strongly suggested. We concluded that surgical treatment for coronary fistula with giant aneurysm can be done with minimal risk.
报道了一例伴有巨大囊状动脉瘤的左冠状动脉-肺动脉瘘的外科病例。在完全体外循环下成功切除了动脉瘤。患者为67岁女性，因胸痛和心脏杂音入院评估。冠状动脉造影显示，诊断为起源于左前降支并引流至肺动脉的冠状动脉瘘。由于合并巨大囊状动脉瘤以及运动心电图显示缺血改变的阳性结果，因此需要进行手术。术中对瘘管进行流量测定显示，估计平均流量为200毫升/分钟，强烈提示存在冠状动脉窃血现象。我们得出结论，对于伴有巨大动脉瘤的冠状动脉瘘，手术治疗的风险可以降至最低。
