Vavuranakis M, Bush C A, Boudoulas H
Division of Cardiology, Ohio State University, Columbus 43210, USA.
Cathet Cardiovasc Diagn. 1995 Jun;35(2):116-20. doi: 10.1002/ccd.1810350207.
The incidence, angiographic characteristics, and natural history of coronary artery fistulas in patients undergoing diagnostic cardiac catheterization have not been well defined. Of 33,600 patients who had diagnostic cardiac catheterization, 34 (0.1%) had coronary artery fistula. Nineteen fistulas originated from the right, 11 from the left anterior descending, and 4 from the circumflex coronary arteries, respectively. The mean ratio of pulmonary to systemic flow was 1.19 +/- 0.33. Only one patient with coexistent atrial septal defect had a pulmonic to systemic flow ratio > 1.5. Right and left heart pressures, with the exception of three patients in whom left ventricular end-diastolic pressures was > 12 mm Hg, were within normal limits. During a mean follow-up period of 6.3 years (range 2-14 years), there were no complications related to coronary artery fistula. It was concluded that the incidence of coronary artery fistulas detected during diagnostic coronary angiography is very low. Coronary artery fistulas originate predominantly from the right coronary artery and are not associated with hemodynamic abnormalities or other congenital heart diseases. The prognosis of coronary artery fistulas in adults is good.
接受诊断性心导管检查的患者中冠状动脉瘘的发生率、血管造影特征及自然病史尚未明确界定。在33600例接受诊断性心导管检查的患者中，34例（0.1%）患有冠状动脉瘘。其中19例瘘起源于右冠状动脉，11例起源于左前降支，4例起源于回旋支冠状动脉。肺循环与体循环血流量的平均比值为1.19±0.33。仅1例合并房间隔缺损的患者肺循环与体循环血流量比值>1.5。除3例左心室舒张末期压力>12 mmHg的患者外，左右心压力均在正常范围内。在平均6.3年（范围2 - 14年）的随访期内，未出现与冠状动脉瘘相关的并发症。得出的结论是，诊断性冠状动脉造影时检测到的冠状动脉瘘发生率非常低。冠状动脉瘘主要起源于右冠状动脉，且与血流动力学异常或其他先天性心脏病无关。成人冠状动脉瘘的预后良好。
