先天性冠状动脉瘘的外科治疗()
《中国胸心血管外科临床杂志》[ISSN:1007-4848/CN:51-1492/R]
- 期数:
- 2010年第17卷第1期
- 页码:
- 22-25
- 栏目:
- 临床研究论著
- 出版日期:
- 2010-02-25
文章信息/Info
- Title:
- Surgical Treatment for Patients with Congenital Coronary Artery Fistula
- 文章编号:
- 1007-4848（2010）01-0022-04
- 作者:
- 匡锋 周新民 胡建国 等
- 中南大学湘雅二医院 胸心外科， 长沙 410011
- Author(s):
- KUANG Feng; ZHOU Xin-min; HU Jian-guo; et al .
- Department of Thoracic and Cardiovascular Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, P. R. China
- 分类号:
- R654.2
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 总结外科手术治疗冠状动脉瘘的临床经验及治疗结果，以提高对该类疾病的治疗效果。 方法 对2003年1月至2008年12月收治的47例冠状动脉瘘患者的临床资料进行回顾性分析，其中男25例，女22例；年龄9个月~63岁，平均年龄34岁。47例中有32例患者在非体外循环下行手术治疗修补瘘口；10例瘘口较大者在体外循环下施行手术，直接缝合或补片修补瘘口；对合并心脏畸形的患者同期做相应的矫治。 结果 瘘口发生于右冠状动脉26例，左冠状动脉17例，双侧冠状动脉4例；瘘入右心室17例，右心房8例，肺动脉12例，冠状静脉窦2例，左心房3例，左心室5例；多瘘口4例。全组无手术死亡；仅1例多瘘口患者术后发现残余瘘，其余患者手术效果良好。随访47例，随访时间1个月~5年，除1 例多瘘口患者术后残留一小瘘口外，其余患者复查心脏彩色超声心动图均无异常。 结论 冠状动脉瘘可导致患者出现需要手术干预的血流动力学紊乱，外科手术治疗冠状动脉瘘疗
效确切。
- Abstract:
- Objective To improve the treatment effectiveness of coronary artery fistula by summarizing and analyzing the clinical experiences of its surgical procedures. Methods We retrospectively analyzed the clinical data of 47 patients, 25 males and 22 females, with coronary artery fistula who were hospitalized from January 2003 to December 2008. The age of the patients ranged from 9 months to 63 years old(mean age of 34 years). Thirtytwo cases without associated intracardiac abnormalities were given surgical closure of fistula without cardiopulmonary bypass. Ten cases with largesize fistula were repaired directly or with a patch under cardiopulmonary bypass. Coexisted heart abnormalities were treated simultaneously. Results There were 26 cases of right coronary artery fistula,17 cases of left coronary artery fistula and 4 cases of fistula of both coronary arteries; 17 cases of coronary artery fistula opening into the right ventricle, 8 cases opening into the right atrium, 12 cases opening into the pulmonary artery, 2 cases opening into the sinus of coronary veins, 3 cases opening into the left atrium, 5 cases opening into the left ventricle; and there were 4 cases of multiple fistulas. No death happened during the operation. All patients received surgical treatment successfully, except for one multiplefistula patient who had remaining fistula after operation. Followup was conducted on 47 patients with the time period ranging from 1 month to 5 years. The color ultrasonic cardiography showed that all patients recovered well except for one multiplefistula patient who had a small remaining fistula. Conclusion Coronary artery fistulas can cause hemodynamic problems with indication for surgical intervention. Surgical operation is quite effective for fistulas of coronary artery.
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更新日期/Last Update: 2010-03-04