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冠状动脉-肺动脉瘘为闭塞的左前降支动脉提供侧支血流。

Coronary-Pulmonary Artery Fistula Provides Collateral Flow to an Occluded Left Anterior Descending Artery.

作者信息

Takahashi Baku, Fumoto Hideyuki, Nakayama Yoshihiro

机构信息

Department of Cardiovascular Surgery, Osumi-Kanoya Hospital, Kanoya, Kagoshima, Japan.

出版信息

Ann Vasc Dis. 2024 Sep 25;17(3):301-303. doi: 10.3400/avd.cr.23-00113. Epub 2024 Jul 2.

DOI:10.3400/avd.cr.23-00113
PMID:39359562
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11444823/
Abstract

A 59-year-old man presented with angina. Coronary angiography revealed an occlusion in the proximal left anterior descending artery (LAD), the distal segment of which was supplied by the collateral flow of a coronary-pulmonary arterial fistula (CPAF), originating from the right coronary artery and left sinus of Valsalva. Myocardial scintigraphy revealed ischemia in the anteroseptal region. Coronary artery bypass surgery was performed on the LAD, and the CPAF drains were closed. The CPAF may serve as collateral circulation. Even when CPAF serves as collateral circulation, open surgery could be indicated if the collateral flow is insufficient and the structure is complicated.

摘要

一名59岁男性因心绞痛就诊。冠状动脉造影显示左前降支近端闭塞，其远端由起源于右冠状动脉和左冠窦的冠状-肺动脉瘘（CPAF）的侧支循环供血。心肌闪烁显像显示前间隔区域缺血。对左前降支进行了冠状动脉搭桥手术，并封闭了CPAF引流。CPAF可作为侧支循环。即使CPAF作为侧支循环，若侧支血流不足且结构复杂，仍可考虑进行开放手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6684/11444823/17b62b930baa/avd-17-301-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6684/11444823/eff8670355c5/avd-17-301-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6684/11444823/17b62b930baa/avd-17-301-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6684/11444823/eff8670355c5/avd-17-301-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6684/11444823/17b62b930baa/avd-17-301-g002.jpg

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本文引用的文献

1
Coronary Artery Fistulas: Indications, Techniques, Outcomes, and Complications of Transcatheter Fistula Closure.冠状动脉瘘：经导管瘘口封堵的适应证、技术、结果和并发症。
JACC Cardiovasc Interv. 2021 Jul 12;14(13):1393-1406. doi: 10.1016/j.jcin.2021.02.044.
2
Coronary arteriovenous fistulae: a review.冠状动脉瘘：综述
Int J Angiol. 2014 Mar;23(1):1-10. doi: 10.1055/s-0033-1349162.
3
Left circumflex coronary-to-pulmonary artery fistula as the exclusive collateral to the occluded left anterior descending artery.左旋支冠状动静脉瘘是闭塞的前降支动脉的唯一侧支循环。
Heart Lung Circ. 2014 Jan;23(1):e1-3. doi: 10.1016/j.hlc.2013.05.642. Epub 2013 Jun 19.
4
Coronary artery fistula.冠状动脉瘘。
Ann Thorac Surg. 2012 Jun;93(6):2084-92. doi: 10.1016/j.athoracsur.2012.01.114. Epub 2012 May 5.
5
Coronary-pulmonary fistula serving as a collateral source to the occluded coronary artery in a patient with myocardial infarction.
Int J Cardiol. 2007 Feb 14;115(3):408-9. doi: 10.1016/j.ijcard.2006.01.047. Epub 2006 Jun 9.
6
Exercise thallium-201 scintigraphy in the localization of myocardial ischaemia.运动铊-201心肌闪烁显像在心肌缺血定位中的应用。
Clin Physiol. 1989 Dec;9(6):555-65. doi: 10.1111/j.1475-097x.1989.tb01009.x.