Department of Cardiovascular Surgery, Hospital Universitari i Politecnic La Fe, Valencia, Spain.
Department of Cardiovascular Surgery, Hospital Universitari i Politecnic La Fe, Valencia, Spain.
Ann Thorac Surg. 2020 Jul;110(1):e1-e4. doi: 10.1016/j.athoracsur.2019.11.051. Epub 2020 Jan 23.
A giant coronary artery aneurysm is an infrequent anomaly encountered as an incidental finding. An even more rare condition is its association with a coronary artery fistula. We report the case of a 61-year-old woman that combines two of the rarest coronary anomalies: a 70-mm giant circumflex aneurysm with an arteriovenous fistula tract draining to the superior vena cava. Considering the unique display of anatomy, the surgery was guided with 3-dimensional printing technology. Direct fistula occlusion near its outflow union, orifice source closure, aneurysmal sac exclusion, and two coronary artery bypass grafts were surgically performed. The postoperative course was satisfactory.
巨大冠状动脉瘤是一种罕见的异常，通常作为偶然发现。更为罕见的是其与冠状动脉瘘相关。我们报告了一例 61 岁女性病例，该病例同时合并两种最罕见的冠状动脉异常：70mm 巨大回旋动脉瘤和一条静脉瘘道，引流至上腔静脉。考虑到解剖结构的独特性，手术采用了 3 维打印技术进行指导。在其流出汇合处附近直接进行瘘管闭塞、开口源封闭、动脉瘤囊排除以及两条冠状动脉旁路移植术。术后过程令人满意。
