较大右冠状动脉-右房瘘介入治疗一例

患，男性，18岁，身高178cm，体重72kg。3个月前突发晕厥1次，当地医院就诊发现心脏杂音。2005年11月1日收住我院。既往无发绀、胸闷及喜蹲踞史。查体：血压110／78mmHg（1mmHg=0．133kPa），呼吸频率18次／min，心率82次／min。一般情况好，全身无紫绀，双肺呼吸音清晰。心前区无隆起及异常搏动，胸骨左缘3～4肋间触及收缩期震颤，心界不大，胸骨左缘3～4肋间闻收缩期和舒张期连续性杂音。肝未触及，双下肢无水肿，无杵状指（趾）。心脏超声诊断：右冠状动脉瘘，分流部位不清。2005年11月17日行心导管检查。穿刺右侧股动、静脉，放置6F、7F动脉鞘，全身肝素化。主动脉瓣上造影显示右冠状动脉-右房瘘（图1）。左冠状动脉造影正常。右冠状动脉瘘管口造影因分流量大，右冠状动脉及瘘管不能清晰显示全貌（图2）。     

左冠状动脉右房瘘合并感染性心内膜炎1例

1病历资料患者女,14岁,因"反复发热5个月"于2011-05-22入院。主要症状:5个月反复发热、咳嗽、咳痰,发热无规律,最高体温40℃,伴有寒战、心率加快、乏力、夜间盗汗,偶有关节疼痛,无胸痛、胸闷、呼吸困难等症状。在各级医院诊断"肺部感染",治疗后病情控制不佳。入院时心、肺、腹查体未见异常。送检血培养提示草绿色链球菌生长。第一次超声心     

先天性右冠状动脉右房瘘2例报告

冠状动静脉瘘(CAVF)是指冠状动脉及其分支与任一心腔或冠状窦及其静脉属支、近心大血管(如肺动脉、肺静脉、上腔静脉)之间存在的异常交通。因大多数瘘进入右心系统,常被称为冠状动静     

左冠状动脉右房瘘1例

患儿 ,男 ,7岁 ,发现心脏杂音 1 0 d入院。体检 :发育稍差 ,两肺呼吸音清 ,心界左大 ,心律整齐 ,P2亢进 ,胸骨左缘第 2肋间闻及 级表浅的连续性杂音 ,性质较柔和。心脏 X线三位片示肺血增多 ,呈二尖瓣普大型 ,肺动脉段稍突 ,心胸比 =0 .57。心电图 :窦性心律 ,电轴显著左偏 ,极度顺钟向转位并左前半分支传导阻滞。超声心动图 :各房室不大 ,房间隔连续 ,主动脉无增宽。心底短轴切面见左冠状动脉扩张 ,内径达 8.1 mm,显示长度约 1 2 mm,沿其走向可见瘘口开口于右房。连续波多普勒示瘘口至右房侧双期连续性填充血流频谱 ,峰值流速 2 .41m/s。…     

冠状动脉介入治疗右冠状动脉肺动脉瘘并发右冠状动脉狭窄1例

患者,男,76岁,主诉因反复心前区憋闷10余年加重伴发作性心前区疼痛1周入院.有吸烟史20年,20支/d,高血压史10余年,最高血压为220/100mmHg(1 mmHg=0.133 kPa).入院体检:血压130/70 mmHg,双肺呼吸音清,心率70次/min,心律齐,未及杂音.下肢不水肿.心电图Ⅰ、aVL、V4～6导联T波倒置.空腹血糖5.1 mmol/L,TC 4.25mmol/L,TG 0.67 mmol/L,LDL 2.54 mmol/L,D-二聚体0.1 mg/L(正常＜0.3 mg/L).心动超声:左室肥厚,主动脉瓣少量反流,左室射血分数(LVEF)60%.     

右冠状动脉右室瘘并心内膜炎一例

1 病倒资料 患者男性,31 岁,因"发热伴咳嗽咳痰 4 d"于 2019 年 8月26 日收住我院呼吸内科. 入院前 4 d 前因感冒受凉后出现发热,伴咳嗽、咳白痰,体温最高39. 5℃,在社区诊所给予"头孢类抗生素"静滴2 d,未见明显好转,遂转入上级医院诊治.既往史:既往体健,有吸烟及饮酒嗜好,无药物、毒品成瘾史...     

右冠状动脉-左心室瘘1例

患者,女,28岁。因体检发现心脏杂音而于2002年入院。     

左冠状动脉回旋支右房瘘使用Amplatzer动脉导管封堵器封堵成功一例

1临床资料患者,男性,10岁,发现心脏杂音8年入院。8年前因感冒就诊发现心脏杂音（具体不详）,当时未予特殊治疗。2009年在多家医院多次行心脏彩超、冠脉双源CT提示：左冠状动脉右房瘘可能并左冠状动脉窦瘤（约1．8cm×1．8cm）,房缺可能;右心房、右心室、左心室扩大,二尖瓣、肺动脉轻度反流。院外曾有冠脉造影提示未发现冠脉异常,故到我院诊治。     

右冠状动脉极度扩张并左室瘘一例

患者，女性，39岁，因反复胸闷、气短5年，查体发现心脏杂音2d入院，胸闷、气短多于劳累时发生，休息后很快好转。能承受一般家务劳动。入院检查：口唇无发绀，颈静脉无怒张，双下肢无水肿；心尖部及胸骨左、右缘三、四肋间可闻及双期柔和喷射性杂音，以舒张期为主，胸骨左缘三、四肋间杂音最响。心脏彩超检查示：左室舒张末内径56mm，收缩末内径40mm，升主动脉内径41mm。右冠状动脉明显扩张，起始部内径20mm，沿着房间沟走行内径14mm，     

冠状动脉搭桥术治疗冠心病226例临床经验

1993年2月至2003年12月,我们对226例冠状动脉粥样硬化性心脏病患者施行冠状动脉搭桥术,取得了良好效果。现报告如下。     

Colossal left main to right atrium fistula ligation complicated by left circumflex STEMI

Congenital left main (LM) coronary artery to right atrium fistulas with progression to aneurysm development are rare. Most patients remain asymptomatic, but for those with progressive symptoms, intervention is required. However, there are potential life-threatening complications associated with surgical intervention. We present a case of an extremely rare markedly aneurysmal LM to right atrial fistula treated with surgical ligation complicated by inferolateral ST-elevation myocardial infarction several days post-operatively treated successfully using mechanical aspiration thrombectomy, a stent-retriever, balloon angioplasty, and subsequent intravascular ultrasound-guided percutaneous coronary intervention with drug-eluting stent.     

Left main coronary trunk connecting into right atrium with an aneurysmal coronary artery fistula

Congenital coronary artery fistula (CAF) is an infrequent vascular anomaly that establishes a direct link between an epicardial coronary artery and a cardiac chamber, major vessels, or other vascular structures. In this case there was an aneurysmal-CAF between a left main trunk and the right atrium, which was initially diagnosed as a Kawasaki disease by transthoracic echocardiography and subsequently confirmed by coronary angiography and multi-slice CT angiography. A multi-slice CT angiography might well become the modality of choice for the characterization of these rare congenital anomalies.     

Percutaneous closure of a coronary fistula between the right coronary artery to the left atrium

We describe a case of a congenital coronary artery fistula of the right coronary artery draining into the left atrium in an eight-year-old boy. The initial diagnosis was made after the detection of a continuous cardiac murmur at the age of six years. Transthoracic echocardiography showed the right coronaric ostium dilatation, the site of drainage in the left atrium and left ventricle volume overload. Catheterization confirmed the diagnosis. The patient underwent percutaneous closure by PDA occluder device. Immediate post-closure angiograms showed complete occlusion of the fistula. The patient showed transient ischemic changes on ECG associated to an increase of plasmatic levels of the cardiac enzyme. ECG and cardiac enzyme were normal one week after the procedure. (Int J Cardiovasc Intervent 2004; 6: 156-159)     

A fistula connecting the right coronary artery to the right atrium: a hitherto undescribed association

A case of double right coronary artery accompanying a fistulous connection is presented. An additional right coronary artery is an extremely rare congenital abnormality. In this case, the second right coronary artery was draining into a cardiac chamber via a fistulous connection. This is the first case in the literature to present these abnormalities coexisting in the same patient.