先天性冠状动脉瘘的外科治疗

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。

Surgical Treatment for Patients with Congenital Coronary Artery Fistula

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). Thirty-two cases without associated intracardiac abnormalities were given surgical closu...