冠状动脉瘘  

Coronary Artery Fistula

作　　者：凌美玲[1] 叶剑定[1] 江一峰[1] 蔡俊[1] 郑志春[1] 郭德文[1] 

机构地区：[1]上海市胸科医院放射科,200030

出　　处：《中国医学计算机成像杂志》2000年第3期176-179,共4页Chinese Computed Medical Imaging

摘　　要：目的：研究分析冠状动脉瘦的临床和影像诊断。材料和方法：收集 ３９例冠状动脉瘘，年龄 ５岁～ ６４岁（平均 ２５． ２岁）；均有主动脉根部或（和）冠状动脉造影（ＤＳＡ １９例，电影造影１２例，大片快速换片８例）。结果：听诊有连续性或双期性杂音２８例，ＥＫＧ正常或大致正常心电图１８例，单支形成瘘３７例，双支形成瘘２例，瘘口在右心室１５例（ＲＣＡ８例，ＬＣＡ７例），右心房７例（ＲＣＡ４例，ＬＣＡ３例），肺动脉８例（ＲＣＡ２例，ＬＣＡ４例，双支２例），冠状静脉窦１例，左心室６例（ＲＣＡ２例，ＬＣＡ４例），左心房２例（ＲＣＡ及ＬＣＡ各１例）。发生在ＲＣＡ１９例，ＬＣＡ２０例，１例瘘口为两个，３８例为单个。３３例手术，手术发现瘘口大小０．２ｃｍ－２．２ｃｍ，合并动脉瘤１１例。结论：先天性冠状动脉瘘较罕见，多瘘向右侧心腔，左右冠状动脉发生率相仿，ＤＳＡ主动脉根部造影能做到正确诊断。Purpose: To study the diagnosis of coronary artery fistula(CAF) clinically and radiologically . Materials and Methods: Angiography of aorta or/and coronary artery were undergone in 39 cases of CAF(aged 5- 64 years , mean 25. 2 years). Chest film and EKG were also taken meanwhile. Results: Continuous or dual - phase murmurs were heard in 28 cases, and normal EKG in 18 cases. Fistula in one artery was seen in 37 cases , and the other two had fistulas in two arteries. Fistulas deluge right ventricle in 15 cases(RCA 8, LCA 7), right atrium in 7 cases(RCA 4, LCA 3), pulmonary artery in 8 cases(RCA 2, LCA 4, bilateral 2), coronary venous sinus in 1 case, left ventricle in 6 cases(RCA 2, LCA 4), and left atrium in 2 cases(RCA 1, LCA 1). Fistulas of 19 cases were seen in RCA, and those of the other 20 cases were seen in LCA. The orifice of fistula measured 2 - 22mm by operation, accompanied with 11 aneurysms. Conclusion: The congenital CAF was rare, most of them deluge right chamber.RCA and LCA had a similar morbidi- ty. Angiography of aorta by DSA could detect a correct diagnosis.

关 键 词：冠状动脉瘘 冠状动脉造影 DSA 诊断 

分 类 号：R654.2[医药卫生—外科学]