Fukada J, Inaoka M, Takada T, Oimatsu H, Iwakura M, Hayase A, Shiiki M, Hukuoka M, Hase M
Department of Thoracic Surgery, Hakodate Goryokaku Hospital, Japan.
Kyobu Geka. 1995 Jul;48(7):564-7.
A 52-year-old woman was diagnosed by echocardiography to have a fistula of the right coronary artery (RCA) and the right atrium (RA). Aortography demonstrated a remarkably dilated and undulating fistulous tract originating from the region corresponding to the orifice of the normal RCA. The fistulous tract detoured to the posterior wall of the RA, and forming 2 aneurysms there, opened to the RA. A RCA of normal size originating midway of the fistulous tract was also observed. The patient was operated on under cardio-pulmonary bypass. Aortocoronary saphenous vein graft to the RCA having normal diameter was performed, and the RCA was ligated in the proximal side of the anastomosis. The orifice of the fistulous tract from the aorta was closed with a patch and the entrances into the RA were also closed by pledgetted mattress sutures. The post operative course was uneventful and the patient is now doing well without any complaints.
一名52岁女性经超声心动图诊断为右冠状动脉（RCA）与右心房（RA）瘘。主动脉造影显示，一条显著扩张且呈波浪状的瘘管起源于正常RCA开口对应的区域。瘘管迂曲至RA后壁，在那里形成2个动脉瘤，并通向RA。还观察到一条正常大小的RCA起源于瘘管中途。患者在体外循环下接受手术。对直径正常的RCA进行了主动脉冠状动脉大隐静脉移植，并在吻合口近端结扎了RCA。用补片封闭了来自主动脉的瘘管开口，并用带垫片的褥式缝线封闭了进入RA的入口。术后过程顺利，患者目前情况良好，无任何不适主诉。
