Omair Shah, Naseer Choh, Faiz Shera, Asma Gulzar, Ishfaq Zargar, Feroze Shaheen, Aaqib Manzoor
Department of Radiology, SKIMS SOURA, J&K, India.
Radiol Case Rep. 2021 Feb 2;16(4):888-890. doi: 10.1016/j.radcr.2021.01.045. eCollection 2021 Apr.
True cardiac arteriovenous malformations are rare anomalies that may be acquired or congenital in origin. These anomalies are well demonstrated by Multi Detector Computed Tomography (MDCT) with much higher clarity and anatomic detail than invasive angiography. We report a case of large complex cardiac vascular malformation in 55 year old male involving feeders from systemic (internal mammary artery, right inferior phrenic artery), coronary (left anterior descending), and pulmonary arterial and venous systems using a 64 slice MDCT scanner. Cardiac AV malformations have previously been described using MDCT, but this case is unique in terms of its large size, extensive involvement of systemic, coronary and pulmonary vascular connections, and mild clinical symptomatology. Our case shows that patients with complex coronary malformation may not always require treatment as natures' pathways may work well throughout lifetime.
真正的心脏动静脉畸形是罕见的异常情况，其起源可能是后天获得性的或先天性的。与有创血管造影相比，多排螺旋计算机断层扫描（MDCT）能更清晰、更详细地显示这些异常情况。我们报告一例55岁男性的大型复杂性心脏血管畸形病例，该病例使用64层MDCT扫描仪显示其供血血管来自体循环（胸廓内动脉、右膈下动脉）、冠状动脉（左前降支）以及肺动脉和静脉系统。此前已有使用MDCT描述心脏动静脉畸形的报道，但该病例在其巨大的尺寸、体循环、冠状动脉和肺血管连接的广泛累及以及轻微的临床症状方面具有独特性。我们的病例表明，患有复杂性冠状动脉畸形的患者可能并不总是需要治疗，因为自然的循环路径可能在一生中都能良好运作。
