Coronary-cameral fistulas in adults: Acquired types(second of two parts)  

作　　者：Salah AM Said Rikke HM Schiphorst Richard Derksen Lodewijk J Wagenaar 

机构地区：[1]Department of Cardiology,Hospital Group Twente [2]Department of Cardiology,Thoraxcentrum Twente,Medisch Spectrum Twente [3]Department of Cardiology,Rijnstate Hospital

出　　处：《World Journal of Cardiology》2013年第12期484-494,共11页世界心脏病学杂志（英文版）（电子版）

摘　　要：Acquired coronary artery fistulas(CCFs)are infrequently detected during conventional coronary angiography.To delineate the characteristics of congenital(first part)and acquired(second part)CCFs in adults,a PubMed search was conducted for papers dealing with congenital or acquired CCFs.None of the publications describing patients with coronary-vascular fistulas were included.Papers dealing with pediatric subjects were excluded.From the world literature,a total of 243adult patients were selected who had congenital(n=159/243,65%)and acquired(n=84/243,35%)CCFs.Among the acquired types(n=72,85.7%)were traumatic(iatrogenic(n=65/72,90%),accidental(n=7/72,10%)and(n=12,14.3%)spontaneously developing in relation to severe coronary atherosclerosis or myocardial infarction.A high incidence of spontaneousresolution of iatrogenic CCFs resulting from endomyocardial biopsy or following post-septal myectomy was reported.Spontaneous CCFs associated with myocardial ischemia or infarction resolved completely in 8%of the subjects.Early surgical intervention was the treatment of choice in acquired traumatic accidental CCFs.The congenital types are addressed in a previous issue of this journal(first part).In this review(second of two parts,partⅡ),we describe the acquired coronarycameral fistulas.Acquired coronary artery fistulas(CCFs)are infrequently detected during conventional coronary angiography.To delineate the characteristics of congenital(first part)and acquired(second part)CCFs in adults,a PubMed search was conducted for papers dealing with congenital or acquired CCFs.None of the publications describing patients with coronary-vascular fistulas were included.Papers dealing with pediatric subjects were excluded.From the world literature,a total of 243adult patients were selected who had congenital(n=159/243,65%)and acquired(n=84/243,35%)CCFs.Among the acquired types(n=72,85.7%)were traumatic(iatrogenic(n=65/72,90%),accidental(n=7/72,10%)and(n=12,14.3%)spontaneously developing in relation to severe coronary atherosclerosis or myocardial infarction.A high incidence of spontaneousresolution of iatrogenic CCFs resulting from endomyocardial biopsy or following post-septal myectomy was reported.Spontaneous CCFs associated with myocardial ischemia or infarction resolved completely in 8%of the subjects.Early surgical intervention was the treatment of choice in acquired traumatic accidental CCFs.The congenital types are addressed in a previous issue of this journal(first part).In this review(second of two parts,partⅡ),we describe the acquired coronarycameral fistulas.

关 键 词：ACQUIRED coronary-cameral FISTULAS ACCIDENTAL coronary-cameral FISTULAS IATROGENIC coronarycameral FISTULAS SPONTANEOUS coronary-cameral FISTULAS CORONARY angiography Spontaneous resolution Surgical treatment 

分 类 号：R541.1[医药卫生—心血管疾病]