摘要
目的评价经导管封堵治疗巨大型冠状动脉瘘(coronary artery fistula,CAF)的临床效果与安全性。方法对2006年11月至2010年8月在我科住院并接受经导管封堵治疗的8例巨大型冠状动脉瘘患者的术前、术中及术后1、3、6个月及1、2年的临床随访资料进行回顾性分析,并进行自身前后对照研究。结果 8例巨大型CAF患者中男性5例,女性3例,年龄8～68(30.38±22.83)岁。病变类型包括右冠状动脉-右室瘘4例、右冠状动脉-左室瘘3例、左冠状动脉-右房瘘1例。患者经导管封堵治疗均获成功,术后心脏杂音消失,冠状动脉造影及超声心动图检查均未见残余分流。随访24～36(30.63±3.85)个月。术后2年右心室、右心房、左心房及左心室内径均较术前明显缩小(P<0.05),左心室射血分数(left ventricular ejection fraction,LVEF)则较术前有明显提高(P<0.01),无封堵术相关并发症发生。结论经导管封堵巨大型CAF安全、有效,有助于改善患者心脏结构重塑及心脏功能,有临床推广应用价值。
Objective To evaluate the clinical efficacy and safety of transcatheter closure in treatment of giant coronary artery fistula. Methods Eight cases with giant coronary artery fistula treated with interventional occlusion treatment in our department during November 2006 to August 2010 were enrolled in this study. There were 5 males and 3 females, with an average age of 30.38 ＋ 22.83 （ ranging from 8 to 68 ）. There were 4 cases of right coronary artery-right ventricular fistula （ RCA-RV）, 3 cases of right coronary artery-left ventricular fistula （RCA-LV）, and 1 case of left coronary artery-right atrial fistula （LCA-RA）. They were followed up for an average time of 30.63 _＋ 3.85 months （ ranging from 24 to 36 months）. Their clinical data before, during, in 1, 3 and 6 months, and 1 and 2 years after operation were collected and analyzed as self- controlled trial. Results All patients were successfully treated with transcatheter occlusion. No heart murmur was found in all cases after closure. Coronary angiography and echoeardiography found no residual shunt. Compared with before operation, the right ventricle, right atrium, left atrium and left ventricular were reduced significantly in size （P 〈0.05 ）, and the left ventricular ejection fraction （LVEF） was improved conspicuously （P 〈 0. 001 ）. No complication related to transcatheter closure occurred. Conclusion Percutaneous closure is a safety and efficient approach in treatment of giant coronary artery fistula. It improves heart remodeling and heart functions.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2013年第7期673-675,共3页
Journal of Third Military Medical University
基金
重庆市科技攻关项目(CSTC2011AC5029,CSTC2010AC5030)~~
关键词
冠状动脉瘘
心脏插管术
介入治疗
经皮导管封堵术
coronary arterial fistula
cardiac catheterization
percutaneous treatment
transcatheterclosure
