Urrutia-S C O, Falaschi G, Ott D A, Cooley D A
Ann Thorac Surg. 1983 Mar;35(3):300-7. doi: 10.1016/s0003-4975(10)61563-9.
Over a 25-year period, 58 patients underwent evaluation or surgical treatment of coronary artery fistulas, or both, at our institution. Twenty-one patients had major associated cardiac defects, either congenital or acquired, and 9 had multiple fistulas. Fistulas to the left heart were unusual. Exertional angina and dyspnea were the most common presenting symptoms, but most young patients were asymptomatic. Seventy percent had audible heart murmurs. No operative deaths occurred in patients with isolated fistulas. Coronary artery fistulas cause symptoms due to "coronary steal" with resulting myocardial ischemia and, more rarely, marked left-to-right or left-to-left shunting. Definitive surgical correction is safe and effective, with good long-term results.
在25年的时间里，我院有58例患者接受了冠状动脉瘘的评估或手术治疗，或两者皆有。21例患者伴有严重的先天性或后天性心脏缺陷，9例有多处瘘管。瘘管通向左心的情况较为少见。劳力性心绞痛和呼吸困难是最常见的症状，但大多数年轻患者无症状。70%的患者可闻及心脏杂音。孤立性瘘管患者无手术死亡病例。冠状动脉瘘由于“冠状动脉窃血”导致心肌缺血，进而引发症状，更罕见的是出现明显的左向右或左向左分流。确切的手术矫正安全有效，长期效果良好。
