Chen Alexander L, Vivacqua Alessandro, Altshuler Jeffrey M, Shannon Francis L, Gulati Rajesh C, Schwann Thomas A, Kindzelski Bogdan A
Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan.
Department of Cardiovascular Medicine, Corewell East William Beaumont University Hospital, Royal Oak, Michigan.
Ann Thorac Surg Short Rep. 2024 Mar 29;2(3):394-396. doi: 10.1016/j.atssr.2024.03.002. eCollection 2024 Sep.
Coronary-pulmonary artery fistulas (CPAFs) are rare entities that can cause significant left-to-right shunting and complicate routine coronary artery bypass grafting. There are no best practice guidelines and a scarcity of reports regarding concomitant treatment of CPAF with coronary artery disease. We present a case of bilateral CPAFs in a 60-year-old man with symptomatic coronary artery disease treated successfully with coronary artery bypass, epicardial ligation, and transpulmonary closure of CPAF with patch reconstruction. This case highlights the importance of optimal myocardial protection and complete closure of the fistula to prevent risk of coronary steal.
冠状动脉-肺动脉瘘（CPAFs）是一种罕见的疾病，可导致明显的左向右分流，并使常规冠状动脉旁路移植术复杂化。目前尚无最佳实践指南，关于CPAF与冠状动脉疾病的联合治疗的报道也很少。我们报告一例60岁有症状冠状动脉疾病男性患者的双侧CPAFs病例，该患者通过冠状动脉旁路移植术、心外膜结扎术以及用补片重建经肺动脉闭合CPAFs而成功治愈。该病例突出了优化心肌保护和完全闭合瘘管以预防冠状动脉窃血风险的重要性。
