Department of Cardiovascular Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China.
Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China.
Int Heart J. 2023;64(4):775-778. doi: 10.1536/ihj.22-082.
A coronary aneurysm is a rare type of cardiovascular disease. We report a case of a 53-year-old male patient who presented to our hospital with a giant left circumflex coronary fistula aneurysm (LCCA) (75 mm × 70 mm). Since coronary angiography and coronary computed tomography angiography failed to detect the fistula of the coronary aneurysm, interventional occlusion surgery could not be performed. We discovered the fistula in the right atrium by anterograde perfusion with blood-containing myocardial protective fluid after switching to intraoperative exploration during cardiac surgery. The coronary aneurysm's fistula and inlet were then sutured, and the aneurysm was resected. The patient recovered successfully after the operation. This case was instructive in managing LCCA, especially with an unidentified fistula.
冠状动脉瘤是一种罕见的心血管疾病。我们报告了一例 53 岁男性患者，他因巨大的左回旋支冠状动脉瘘瘤（LCCA）（75mm×70mm）就诊于我院。由于冠状动脉造影和冠状动脉计算机断层血管造影未能检测到冠状动脉瘤的瘘管，因此无法进行介入性闭塞手术。在心脏手术中改为术中探查时，我们通过顺行灌注含血心肌保护液发现了右心房的瘘管。然后缝合冠状动脉瘤的瘘管和入口，并切除动脉瘤。术后患者恢复良好。本例对于管理 LCCA 特别是不明原因瘘管具有指导意义。
