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肺栓子切除术时左冠状动脉至肺动脉瘘的纠正(作者译)

[Correction of left coronary artery to pulmonary artery fistula on the occasion of pulmonary embolectomy (author's transl)].

作者信息

Schulte H D, Falke K, Kreutzberg B, Spiller P

出版信息

Thoraxchir Vask Chir. 1978 Dec;26(6):418-21. doi: 10.1055/s-0028-1096665.

Abstract

In a 42 year old woman a left coronary artery to pulmonary artery fistula was proved by catheterization and coronary angiography. During this investigations a right femoral hernia became symptomatic, and surgical correction was carried out. Three days postoperatively a massive pulmonary embolism occurred causing shock and fibrillation of the heart. After intubation the patient was brought to the operating theatre under external massage, and a pulmonary embolectomy using ECC was performed. The fistula in the main pulmonary artery was closed by suture. The vascular convolute was left in place. A primarily additional ligature of the fistula artery at the starting point was reopened because of a failing right ventricle under the assumption of a possible partial vascular supply of the right ventricular myocardium which could not be proved.

摘要

在一名42岁女性患者中,通过心导管检查和冠状动脉造影证实存在左冠状动脉至肺动脉瘘。在这些检查过程中,右侧股疝出现症状,并进行了手术矫正。术后三天发生大规模肺栓塞,导致休克和心脏颤动。插管后,患者在体外按摩下被送往手术室,并使用体外循环进行了肺栓子切除术。主肺动脉内的瘘口通过缝合关闭。血管盘旋结构保留原位。由于右心室功能衰竭,在假设右心室心肌可能存在部分血管供应(但未得到证实)的情况下,重新打开了在起始点对瘘管动脉进行的一期附加结扎。

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