成人先天性锁骨下-上腔静脉动静脉瘘伴初始狭窄：1 例报告。
Congenital subclavian-superior vena cava arteriovenous fistula with initial stenosis in an adult: a case report.
机构信息
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, P.R. China.
出版信息
BMC Cardiovasc Disord. 2020 Aug 17;20(1):376. doi: 10.1186/s12872-020-01660-5.
BACKGROUND
A subclavian-superior vena cava arteriovenous fistula is usually acquired and secondary to trauma or operations, while congenital causes are very rare. A congenital arteriovenous fistula leads to congestive heart failure soon after birth and is typically diagnosed in early infancy.
CASE PRESENTATION
We present an unusual case of a 21-year-old female suffering from new-onset heart failure at 20 years old who was diagnosed with a congenital arteriovenous fistula from the right subclavian artery to the superior vena cava (RSA-to-SVC) with stenosis at the proximal initial site of the fistula. The patient successfully underwent transcatheter occlusion for the fistula and had a significant improvement in symptoms at the 3-month follow-up.
CONCLUSIONS
An RSA-to-SVC fistula is a very rare congenital disorder that can lead to shunt-related heart failure. If there is an indication for closure, as with the patient presented, percutaneous device closure can be considered a reasonable option.
背景
锁骨下-上腔静脉动静脉瘘通常是后天获得的，继发于创伤或手术，而先天性原因非常罕见。先天性动静脉瘘会在出生后不久导致充血性心力衰竭，通常在婴儿早期诊断。
病例介绍
我们报告了一例不常见的病例，一名 21 岁女性在 20 岁时出现新发心力衰竭，被诊断为从右锁骨下动脉到上腔静脉（RSA-to-SVC）的先天性动静脉瘘，并在瘘口近端起始部位存在狭窄。该患者成功接受了经导管瘘口闭塞治疗，在 3 个月随访时症状显著改善。
结论
RSA-to-SVC 瘘是一种非常罕见的先天性疾病，可导致分流相关心力衰竭。如果存在闭合指征，如本例患者所示，经皮器械闭合可以被视为合理的选择。
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