Uchida Tetsuro, Hamasaki Azumi, Kuroda Yoshinori, Ohba Eiichi, Yamashita Atsushi, Sadahiro Mitsuaki
Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Ann Thorac Surg. 2017 Sep;104(3):e261-e263. doi: 10.1016/j.athoracsur.2017.04.020.
Postoperative residual shunting is a significant concern in patients with coronary arteriovenous fistulas, especially in fistulas originating from the proximal left coronary artery, because of the limited surgical field. We report a case of fistulas originating from the proximal coronary artery in a 63-year-old woman in whom the ascending aorta and pulmonary artery were transected to obtain good surgical exposure. After complete transection of both great arteries, fistulas arising from the left main trunk were ligated externally, and their intracardiac openings were closed internally. Postoperative examination revealed no residual shunt flow.
术后残余分流是冠状动脉瘘患者的一个重要问题，尤其是起源于左冠状动脉近端的瘘，因为手术视野有限。我们报告一例63岁女性近端冠状动脉瘘病例，该患者升主动脉和肺动脉被横断以获得良好的手术视野。在完全横断两条大动脉后，从左主干发出的瘘在外部结扎，其心内开口在内部封闭。术后检查未发现残余分流。
