冠状动脉瘘(CAF)是冠状动脉与心腔或大血管间的异常连接,多为先天性,后天性病因包括创伤、感染等。其临床表现与分流量相关,轻者无症状,重者可致心力衰竭、心肌缺血及感染性心内膜炎等。诊断依赖于超声心动图、MRI、CT及冠状动脉造影,...冠状动脉瘘(CAF)是冠状动脉与心腔或大血管间的异常连接,多为先天性,后天性病因包括创伤、感染等。其临床表现与分流量相关,轻者无症状,重者可致心力衰竭、心肌缺血及感染性心内膜炎等。诊断依赖于超声心动图、MRI、CT及冠状动脉造影,其中超声心动图为首选筛查手段。目前的治疗方式包括介入封堵或外科手术,介入治疗创伤小但需严格把握适应症,外科手术多用于复杂病例。介入治疗术后并发症包括血栓、残余分流、心律失常等,远期预后良好,但需长期随访。本文系统综述了儿童冠状动脉瘘的临床表现、诊断、介入治疗现状及预后等。Coronary artery fistula (CAF) is an abnormal connection between a coronary artery and a cardiac chamber or major blood vessel, most commonly congenital in origin. Acquired causes include trauma, infections, and other etiologies. Clinical manifestations depend on the shunt volume: mild cases may be asymptomatic, while severe cases can lead to heart failure, myocardial ischemia, infective endocarditis, and other complications. Diagnosis relies on imaging modalities such as echocardiography, MRI, CT, and coronary angiography, with echocardiography serving as the first-line screening tool. Current treatment options include interventional closure or surgical procedures. Interventional therapy is minimally invasive but requires strict adherence to indications, while surgery is primarily used for complex cases. Postoperative complications of interventional therapy may include thrombosis, residual shunt, arrhythmias, and so on. Although the long-term prognosis is favorable, it necessitates ongoing long-term follow-up monitoring. This article systematically reviews the clinical manifestations, diagnostic approaches, current status of interventional therapies, and prognoses of coronary artery fistulas in children.展开更多
干下型室间隔缺损是一种罕见的先天性心脏病,由于其解剖位置特殊,易导致主动脉瓣脱垂和反流,通常需要早期手术干预。文章讨论了以下几种治疗方法:体外循环下外科手术修补:这是干下型室间隔缺损的传统治疗方法,具有高成功率和可靠性,尤...干下型室间隔缺损是一种罕见的先天性心脏病,由于其解剖位置特殊,易导致主动脉瓣脱垂和反流,通常需要早期手术干预。文章讨论了以下几种治疗方法:体外循环下外科手术修补:这是干下型室间隔缺损的传统治疗方法,具有高成功率和可靠性,尤其适用于低龄或合并肺动脉高压的患儿。利用封堵器介入关闭:经胸介入、经皮介入手术治疗均不需要体外循环,作为微创的手术方式各有优缺点。还包括其他方法如“镶嵌”概念,本文综述了干下型室间隔缺损的内外科治疗发展演变及研究进展。Doubly committed subarterial ventricular septal defect is a rare congenital heart disease characterized by its unique anatomical location, which predisposes to aortic valve prolapse and regurgitation, often necessitating early surgical intervention. This article discusses several treatment methods: surgical repair under cardiopulmonary bypass, which is the traditional treatment for it, with high success rates and reliability, particularly suitable for young children or those with associated pulmonary hypertension. Interventional closure using occluder devices, both percutaneous and transthoracic approaches, do not require cardiopulmonary bypass and have their respective advantages and disadvantages as minimally invasive surgical methods. The article also includes other approaches such as the “hybrid” concept. This review summarizes the evolution and research progress of surgical and interventional treatments for doubly committed subarterial ventricular septal defect.展开更多
文摘冠状动脉瘘(CAF)是冠状动脉与心腔或大血管间的异常连接,多为先天性,后天性病因包括创伤、感染等。其临床表现与分流量相关,轻者无症状,重者可致心力衰竭、心肌缺血及感染性心内膜炎等。诊断依赖于超声心动图、MRI、CT及冠状动脉造影,其中超声心动图为首选筛查手段。目前的治疗方式包括介入封堵或外科手术,介入治疗创伤小但需严格把握适应症,外科手术多用于复杂病例。介入治疗术后并发症包括血栓、残余分流、心律失常等,远期预后良好,但需长期随访。本文系统综述了儿童冠状动脉瘘的临床表现、诊断、介入治疗现状及预后等。Coronary artery fistula (CAF) is an abnormal connection between a coronary artery and a cardiac chamber or major blood vessel, most commonly congenital in origin. Acquired causes include trauma, infections, and other etiologies. Clinical manifestations depend on the shunt volume: mild cases may be asymptomatic, while severe cases can lead to heart failure, myocardial ischemia, infective endocarditis, and other complications. Diagnosis relies on imaging modalities such as echocardiography, MRI, CT, and coronary angiography, with echocardiography serving as the first-line screening tool. Current treatment options include interventional closure or surgical procedures. Interventional therapy is minimally invasive but requires strict adherence to indications, while surgery is primarily used for complex cases. Postoperative complications of interventional therapy may include thrombosis, residual shunt, arrhythmias, and so on. Although the long-term prognosis is favorable, it necessitates ongoing long-term follow-up monitoring. This article systematically reviews the clinical manifestations, diagnostic approaches, current status of interventional therapies, and prognoses of coronary artery fistulas in children.
文摘干下型室间隔缺损是一种罕见的先天性心脏病,由于其解剖位置特殊,易导致主动脉瓣脱垂和反流,通常需要早期手术干预。文章讨论了以下几种治疗方法:体外循环下外科手术修补:这是干下型室间隔缺损的传统治疗方法,具有高成功率和可靠性,尤其适用于低龄或合并肺动脉高压的患儿。利用封堵器介入关闭:经胸介入、经皮介入手术治疗均不需要体外循环,作为微创的手术方式各有优缺点。还包括其他方法如“镶嵌”概念,本文综述了干下型室间隔缺损的内外科治疗发展演变及研究进展。Doubly committed subarterial ventricular septal defect is a rare congenital heart disease characterized by its unique anatomical location, which predisposes to aortic valve prolapse and regurgitation, often necessitating early surgical intervention. This article discusses several treatment methods: surgical repair under cardiopulmonary bypass, which is the traditional treatment for it, with high success rates and reliability, particularly suitable for young children or those with associated pulmonary hypertension. Interventional closure using occluder devices, both percutaneous and transthoracic approaches, do not require cardiopulmonary bypass and have their respective advantages and disadvantages as minimally invasive surgical methods. The article also includes other approaches such as the “hybrid” concept. This review summarizes the evolution and research progress of surgical and interventional treatments for doubly committed subarterial ventricular septal defect.
