Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA.
JACC Cardiovasc Interv. 2021 Jul 12;14(13):1393-1406. doi: 10.1016/j.jcin.2021.02.044.
Coronary artery fistulas (CAFs) are rare coronary anomalies that are usually diagnosed incidentally with cardiac imaging. Small CAFs are generally asymptomatic and can close over time, while some untreated medium or large CAFs can enlarge, leading to clinical sequelae such as cardiac chamber enlargement or myocardial ischemia. With the advancement of transcatheter equipment and techniques, CAFs have been increasingly closed using a percutaneous approach. However, the procedure is not free of limitations given the risk for myocardial infarction, device embolization, and fistula recanalization. In this review, the authors illustrate the contemporary procedural considerations, techniques, and outcomes of transcatheter CAF closure.
冠状动脉瘘（CAF）是一种罕见的冠状动脉畸形，通常在心脏影像学检查中偶然发现。小的 CAF 通常无症状，并随着时间的推移而自行闭合，而一些未经治疗的中等或大的 CAF 则可能会增大，导致心脏腔室扩大或心肌缺血等临床后果。随着经导管设备和技术的进步，越来越多的 CAF 采用经皮途径进行闭合。然而，由于存在心肌梗死、器械栓塞和瘘管再通的风险，该操作并非没有局限性。在这篇综述中，作者阐述了经导管 CAF 闭合的当代操作注意事项、技术和结果。
