摘要
目的:探讨常温非体外循环下,手术治疗先天性冠状动脉瘘(congenital coronary arterial fistula,CAF)的手术方法和远期效果。方法:2001年8月至2009年8月在阜外心血管病医院行常温非体外循环下手术治疗CAF21例。全组年龄12d～60岁,平均(20.6±20.0)岁;20例为单纯的CAF,1例合并冠心病3支病变。21例中瘘口起源于右冠状动脉5例(23.8%),左冠状动脉12例(57.1%),双冠状动脉4例(19.1%);瘘口入右心房,右心室,肺动脉及左心室分别为5例(23.8%),8例(38.1%),7例(33.3%)和1例(4.8%);结果:21例均在常温非体外循环下行冠状动脉瘘结扎或褥式带垫片缝扎,其中1例同时行常温不停跳冠状动脉搭桥术,无手术死亡。术后残余瘘1例,其余术后无心肌缺血及残余瘘等并发症。19例随访0.5～5.5年,平均(2.1±1.7)年,无远期死亡。1例残余瘘,其余无心肌缺血及残余瘘等并发症。结论:常温非体外循环下手术治疗CAF安全、有效,远期效果良好。
Objective：To assess the safety and efficacy of surgical ligation of congenital coronary artery fistula（CAF） without cardiopulmonary bypass.Methods：From 2001 to 2009,21 patients ranging in age from 12 days to 60 years mean（20.6 ± 20.0） years were studied.One patient was associated with coronary artery disease and 20 patients had no coexisting cardiac lesions.The site of fistula origin was the right coronary artery in 5 patients（23.8%）,the left coronary artery in 12 patients（57.1%） and the bilateral coronary artery in 4 patients（19.1%）.The sites of CAF drainage were as follows：right atrium,5 patients（23.8%）;right ventricle,8 patients（38.1%）;pulmonary artery,7 patients（33.3%）;and left ventricle 1 patient（4.8%）.Results：All patients were ligated epicardially without cardiopulmonary bypass.One patient was performed offpump coronary artery bypass when the fistula was ligated.There was no operative mortality and morbidity was low.The duration of follow-up was 0.5 to 5.5 years mean（2.1 ± 1.7） years and all patients were asymptomatic.Conclusion：Surgical ligation of CAF without cardiopulmonary bypass is safe and effective.
出处
《心肺血管病杂志》
CAS
2010年第5期367-370,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
冠状动脉瘘
外科治疗
非体外循环手术
先天性心脏病
Coronary artery fistula
Surgical treatment
Off-pump surgery
Congenital heart disease
