汇入于相同部位的巨大迂曲双侧冠状动脉-右心室瘘1例  

Bilateral coronary artery-right ventricular fistula with rare huge tortuosity entering the same site:case report

作　　者：唐唯淞 许荣丽 蔡兴赳 方小丽 陈关良 李海嵘 TANG Wei-song;XU Rong-Li;CAI Xing-Jiu;FANG Xiao-Li;CHEN Guan-Liang;LI Hai-Rong(Deparment of Cardiology,Hainan Affiliated Hospital of Hainan MedicalUniversity,Hainan General Hospital,Haikou 570100,China)

机构地区：[1]海南医学院附属海南医院、海南省人民医院心血管内科,海南海口570100

出　　处：《中国介入心脏病学杂志》2024年第4期236-240,共5页Chinese Journal of Interventional Cardiology

基　　金：海南省自然科学基金项目(821MS121);海南省临床医学中心建设项目(琼卫医〔2022〕33号)。

摘　　要：冠状动脉瘘是冠状动脉与心腔、大血管或其他血管结构直接连接,绝大多数冠状动脉瘘是先天性的,在无症状的儿童中常表现为持续性杂音。尽管多数冠状动脉瘘的异常分流对血流动力学的影响较小,但一些较大的瘘管也会导致一系列的并发症,例如充血性心力衰竭等。目前闭合冠状动脉瘘已被推荐用于治疗或预防心肌缺血、充血性心力衰竭、心律失常等并发症。冠状动脉瘘属于少见先天性心脏病,而起源于两条冠状动脉的双侧冠状动脉瘘更为少见。目前有关双侧冠状动脉瘘病例少见系统性报道。因此,本病例在报道1例汇入于相同部位的巨大双侧冠状动脉瘘的同时系统性总结了该类病例,以提高临床对此类冠状动脉瘘诊断和治疗的关注。如今,随着心血管介入技术的不断进步,一些新型的介入器材和技术正在不断涌现,使得治疗更加精准、安全和有效。同时,对于介入治疗的适应证和操作规范也有了更为清晰的认识,在治疗过程中更加具有可操作性和可预见性,因此冠状动脉瘘的介入治疗或可部分替代外科手术治疗成为首选的治疗方式。Coronary artery fistula(CAF)is defined as the direct connection between coronary artery and cardiac cavity,great vessel or other vascular structures.Most CAF are congenital and often present as persistent murmur in asymptomatic children.Although abnormal shunt of most coronary fistulas has little effect on hemodynamics,some larger fistulas can also lead to a series of complications,such as congestive heart failure.Therefore,closed CAF has been recommended to treat or prevent myocardial ischemia,congestive heart failure,endarteritis,arrhythmia,thromboembolism,aneurysm dilatation and rupture and other complications.CAF is a rare congenital heart disease,and bilateral CAF originating from two coronary arteries is even rarer.At present,there are rare systematic reports on bilateral CAF.Therefore,a case of huge bilateral CAF at the same site was reported,and systematically,this kind of case was summarized,so as to improve the clinical attention of diagnosis and treatment of this kind of CAF.Nowadays,some new interventional devices and technologies are emerging with the continuous progress of cardiovascular interventional technology,making the treatment more accurate,safe and effective.At the same time,there is also a clearer understanding of the indications and operating standards for interventional treatment,which is more operable and predictable during the treatment process.Therefore,interventional treatment of CAF may partially replace surgical treatment as the preferred treatment method.

关 键 词：双侧冠状动脉-右心室瘘 冠状动脉疾病 冠状动脉异常 

分 类 号：R54[医药卫生—心血管疾病]