Department of Cardiology, Antalya Medical Park Hospital, 07160 Antalya, Turkey.
Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University, 34096 Istanbul, and School of Medicine, Bahcesehir University, 34349 Istanbul, Turkey.
Tex Heart Inst J. 2020 Apr 1;47(2):135-139. doi: 10.14503/THIJ-18-6786.
Coronary artery fistulas are rare anomalies that often become symptomatic with age. They are typically diagnosed incidentally during coronary angiography. The chief nonsurgical treatment is transcatheter coil embolization. We evaluated the outcomes of this procedure in 17 symptomatic patients who had 22 fistulas in total. The 9 men and 8 women (mean age, 52 ± 16.5 yr; range, 27-74 yr) presented at 4 Turkish hospitals from October 2008 through March 2015. Three patients had multiple fistulas. Twelve fistulas originated from the right coronary artery and 10 from the left coronary artery, draining into the pulmonary artery in 18 instances. We evaluated results postprocedurally and after 2 to 5 months, defining angiographic success as a flow better than Thrombolysis in Myocardial Infarction grade 2 in the treated artery. Twenty-one of the 22 procedures immediately produced the targeted flow. We observed 2 minor and no major complications. On follow-up, 3 symptomatic patients underwent successful repeat treatment of one fistula each. We found that transcatheter coil embolization afforded good success rates with few complications in closing coronary artery fistulas. We share our experience to add to the data on treating patients with coronary artery fistulas, and to raise awareness among clinicians.
冠状动脉瘘是一种罕见的异常，通常随着年龄的增长而出现症状。它们通常在冠状动脉造影时偶然被诊断出来。主要的非手术治疗方法是经导管线圈栓塞。我们评估了 17 名有症状的患者（9 名男性，8 名女性；平均年龄 52 ± 16.5 岁；年龄范围 27-74 岁）的 22 个瘘管的治疗结果，这些患者在 2008 年 10 月至 2015 年 3 月期间在 4 家土耳其医院就诊。3 名患者有多发性瘘管。12 个瘘管起源于右冠状动脉，10 个起源于左冠状动脉，其中 18 个瘘管流入肺动脉。我们在术后和 2-5 个月后评估结果，将治疗后的动脉血流优于心肌梗死溶栓治疗分级 2 定义为血管造影成功。22 个手术中有 21 个立即产生了目标血流。我们观察到 2 例轻微并发症，无 1 例严重并发症。在随访中，3 名有症状的患者分别对 1 个瘘管进行了成功的重复治疗。我们发现，经导管线圈栓塞在闭合冠状动脉瘘方面成功率高，并发症少。我们分享我们的经验，以增加关于治疗冠状动脉瘘患者的数据，并提高临床医生的认识。
