Uchida N, Baudet E, Roques X, Laborde N, Billes M A
Department of Cardiovascular Surgery, Hopital Haut-Lévêque, Bordeaux-Pessac, France.
Eur J Cardiothorac Surg. 1995;9(2):106-8. doi: 10.1016/s1010-7940(05)80030-2.
Routine follow-up catheterization 4 years after heart transplantation in a 55-year-old revealed a fistula from the main left anterior descending artery (LAD) to the right ventricle. The left anterior descending artery was dilated and tortuous because of this fistula. As he had effort dyspnea and fatigue 3 months after this catheterization, we decided to operate on the fistula, and direct closure of this through the LAD and coronary artery bypass grafting from the proximal to distal LAD were performed. Surgery and the postoperative course were uneventful. We discuss the surgical indication and technique for coronary artery fistula acquired as a result of endomyocardial biopsy after heart transplantation.
一名55岁患者心脏移植4年后进行常规随访导管检查时，发现左前降支动脉（LAD）至右心室存在瘘管。由于该瘘管，左前降支动脉扩张且迂曲。在此次导管检查3个月后，因患者出现劳力性呼吸困难和疲劳，我们决定对该瘘管进行手术，并通过左前降支动脉直接闭合瘘管，同时进行了从左前降支动脉近端至远端的冠状动脉搭桥术。手术及术后过程均顺利。我们讨论了心脏移植后因心内膜活检导致的冠状动脉瘘的手术指征及技术。
