经皮弹簧圈栓塞及支架植入治疗合并巨大冠状动脉瘤的多发性冠状动脉-肺动脉瘘：一例报告
Percutaneous coil embolization and stent implantation for multiple coronary-to-pulmonary artery fistulas with giant coronary aneurysms: a case report.
作者信息
Nakano Yasuhiro, Matoba Tetsuya, Nagatomo Yusaku, Tsutsui Hiroyuki
机构信息
Department of Cardiovascular Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Department of Pediatrics, Kyushu University Hospital, Fukuoka, Japan.
出版信息
Eur Heart J Case Rep. 2022 Mar 7;6(3):ytac104. doi: 10.1093/ehjcr/ytac104. eCollection 2022 Mar.
BACKGROUND
Multiple coronary-to-pulmonary artery fistulas (CPAFs) with giant coronary aneurysms (CAs) are extremely rare. The appropriate therapeutic indication and strategy for CPAFs have not been established.
CASE SUMMARY
Herein, we report the case of an asymptomatic 74-year-old woman with multiple CPAFs associated with giant CAs that had gradually developed over a 4-year period. After heart team discussion, we were successfully treated by minimally invasive intervention using transcatheter coil embolization and coronary stent implantation to prevent ruptures.
DISCUSSION
Coronary-to-pulmonary artery fistulas required evaluation of the appropriate timing of therapy initiation with reference to the presence of symptoms and fistula and aneurysm sizes, and determination of the optimal therapeutic approach with reference to the anatomy of the fistula with aneurysm and patient background characteristics.
背景
伴有巨大冠状动脉瘤（CA）的多发性冠状动脉-肺动脉瘘（CPAF）极为罕见。目前尚未确立CPAF的合适治疗指征和策略。
病例摘要
在此，我们报告一例74岁无症状女性病例，其患有多发性CPAF并伴有巨大CA，这些病变在4年时间里逐渐发展。经过心脏团队讨论，我们通过经导管线圈栓塞和冠状动脉支架植入的微创干预成功进行了治疗，以预防破裂。
讨论
冠状动脉-肺动脉瘘需要根据症状的存在、瘘管和动脉瘤大小评估开始治疗的合适时机，并根据伴有动脉瘤的瘘管解剖结构和患者背景特征确定最佳治疗方法。
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