Midell A I, Bermudez G A, Replogle R
J Thorac Cardiovasc Surg. 1977 Aug;74(2):199-203.
Surgical closure of a left coronary artery-left ventricular fistula in a 44-year-old black man is reported. The fistula was discovered by coronary arteriography after the patient was admitted to the hospital complaining of recurrent chest pain. The fistula was closed with cardiopulmonary bypass, ischemic arrest, and hypothermia, and there was an uneventful postoperative recovery. The previously reported five cases of fistulas terminating in the left ventricle that were closed surgically are reviewed. Four of these cases originated in the right coronary artery and one in the left coronary artery. Three of the six patients were symptomatic at the time of discovery of the lesion. Cardiopulmonary bypass was necessary in five of the six cases. One patient died in the postoperative period from intractable hemorrhage. It is recommended that coronary artery fistulas by closed upon establishment of the diagnosis because of the sequelae if they are allowed to remain open; these include premature atherosclerosis, aneurysmal dilatation of the coronary artery, and congestive heart failure.
报道了一名44岁黑人男性左冠状动脉-左心室瘘的手术闭合情况。该患者因反复胸痛入院，经冠状动脉造影发现瘘管。通过体外循环、缺血停搏和低温技术成功闭合了瘘管，术后恢复顺利。回顾了此前报道的5例经手术闭合的终止于左心室的瘘管病例。其中4例起源于右冠状动脉，1例起源于左冠状动脉。6例患者中有3例在发现病变时出现症状。6例中有5例需要体外循环。1例患者术后因顽固性出血死亡。鉴于冠状动脉瘘若任其开放会引发诸如过早动脉粥样硬化、冠状动脉瘤样扩张和充血性心力衰竭等后遗症，建议一旦确诊即行闭合。
