Bessho Saki, Tanaka Keizo, Hashimoto Takashi, Hiraiwa Takane
Department of Cardiovascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
Kyobu Geka. 2020 Mar;73(3):220-222.
Coronary-pulmonary artery fistula( CPAF) is a relatively rare congenital malformation. We successfully treated a patient who presented with cardiac tamponade due to ruptured CPAF. A 58-year-old woman was admitted to our hospital due to consciousness disorder. Enhanced computed tomography revealed hemopericardium, and she was diagnosed with cardiac tamponade due to a ruptured coronary artery aneurysm with fistula arising from the right coronary and entering the main pulmonary artery. Therefore, emergency operation was performed. Under cardiopulmonary bypass, the aneurysm was opened and the ostium of the fistula was closed with pledgetted mattress sutures. After ligating the tortuous CPAF, the aneurysmal wall was sutured. Postoperative course was uneventful, and she was discharged on postoperative day 16.
冠状动脉-肺动脉瘘(CPAF)是一种相对罕见的先天性畸形。我们成功治疗了一名因CPAF破裂导致心脏压塞的患者。一名58岁女性因意识障碍入院。增强计算机断层扫描显示心包积血,她被诊断为因右冠状动脉瘘破裂形成动脉瘤并进入主肺动脉导致心脏压塞。因此,进行了急诊手术。在体外循环下,打开动脉瘤,用带垫片的褥式缝线封闭瘘口。结扎迂曲的CPAF后,缝合动脉瘤壁。术后过程顺利,她于术后第16天出院。