徐亮,徐仲英,蒋世良,郑宏,赵世华,凌坚,张戈军

• 1:中国医学科学院北京协和医学院阜外心血管病医院心血管病研究所放射科

摘要(Abstract)：

目的评价小儿冠状动脉瘘的介入治疗效果。方法 13例患有先天性冠状动脉瘘的儿童(男性7例,年龄3～10岁),均于2005至2008年期间接受介入治疗。术前造影显示,冠状动脉瘘起自右冠状动脉、左前降支及左回旋支分别为8例、4例及1例;引流入右房、右室及左室分别为9例、3例及1例,且均为单一瘘口。13例患儿均接受介入治疗。结果在介入治疗的过程中,4例患儿选择Cook弹簧钢圈,9例选择PDA封堵器。术后重复造影显示,12例(92.3%)患儿达到完全封堵的效果,1例(7.7%)患儿可见少量残余分流。13例患儿介入治疗操作均获成功,技术成功率为100%。术后短期随访显示原有心内分流均消失,无残余瘘及瘘口再通等情况出现。结论应用Cook弹簧钢圈及PDA封堵器治疗冠状动脉瘘是一种安全及有效的方法,其近期疗效满意。

关键词(KeyWords)： 冠状动脉瘘;介入治疗;Cook弹簧钢圈;PDA封堵器

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 徐亮,徐仲英,蒋世良,郑宏,赵世华,凌坚,张戈军

参考文献(References)：

• [1]Armsby LR,Keane JF,Sherwood MC,et al.Management of coronary artery fistula.Patient selection and results of transcatheter closure.J Am Coll Cardiol,2002,39:1026-1032.
• [2]Aytac A,Bilgic A,Olga R,et al.Congenital right coronary artery-right atrial fistula.Jpn Heart J,1980,21:409-415.
• [3]Bogers AJ,Quaegebeur JM,Huysmans HA.Early and late results of surgical treatment of congenital coronary artery fistula.Thorax,1987,42:369-373.
• [4]刘加立蒋世良.冠状动脉瘘的介入治疗.中国介入心脏病学杂志,2004,12:367-368.
• [5]Liang CD,Ko SF.Midterm Outcome of Percutaneous Transcatheter Coil Occlusion of Coronary Artery Fistula.Pediatr Cardiol,2006,27:557-563.
• [6]Schumacher G,Roithmaier A,Lorenz HP,et al.Congenital coronary artery fistula in infancy and childhood:diagnostic and therapeutic aspects.Thorac Cardiovasc Surg,1997,45:287-294.
• [7]王树水,张智伟,李渝芬,等.经导管介入法治疗小儿先天性冠状动脉瘘9例.中国实用儿科杂志,2005,10:591-593.
• [8]Olgunturk R,Kula S,Tunaoglu FS.Transcatheter closure of a rare form of coronary arteriovenous fistula(circumflex artery to coronary sinus).Int J Cardiol,2006,113:261-263.
• [9]Reidy JF,Anjos RT,Qureshi SA,et al.Transcatheter embolization in the treatment of coronary artery fistulas.J Am Coll Cardiol,1991,18:187-192.
• [10]Sreedharan M,Prasad G,Barooah B,et al.Vortex coilembolisationof coronary artery fistula.Int J Cardiol,2004,94:323-324.
• [11]Sadiq M,Wilkinson JL,Qureshi SA.Successful occlusion of a coronary arteriovenous fistula using an Amplatzer duct occluder.Cardiol Young,2001,11:84-87.
• [12]Okubo M,Nykanen D,Benson LN.Outcomes of transcatheter embolisation in the treatment of coronary artery fistulas.Catheter Cardiovasc Interv,2001,52:510-517.
• [13]Perry SB,Rome J,Keane JF,et al.Transcatheter closure of coronary artery fistulas.J Am Coll Cardiol,1992,20:205-209.
• [14]Petrie MC,Peels JO,Jessurun G.The role of covered stents:More than an occasional cameo?Catheter Cardiovasc Interv,2006,68:21-28.
• [15]Habermann JH,Howard ML,Johnson ES.Rupture of the coronary sinus with Hemopericardium.A rare complication of coronary arteriovenous fistula.Circulation,1963,28:1143-1144.
• [16]Villavicencio R,Marenco R,Zenteno MA,et al.Selective coronary artery fistula embolization with hystoacryl during percutaneous coronary angioplasty.J Invasive Cardiol,2003,15:80-83.
• [17]Trehan V,Yusuf J,Mukhopadhyay S,et al.Transcatheter closure of coronary artery fistulas.Indian Heart J,2004,56:132-139.
• [18]Reidy JF,Sowton E,Ross DN.Transcatheter occlusion of coronary to bronchial anastomosis by detachable balloon combined with coronary angioplasty at same procedure.Br Heart J,1983,49:284-287.
• [19]Gillebert C,Van Hool R,Van De Werf F,et al.Coronary artery fistulas in an adult population.Eur Heart J,1986,7:437-443.
• [20]Mavroutis C,Backer C,Rocchini A,et al.Coronary artery fistulas in infants and children:a surgical review and discussion of coil embolization.Ann Thorac Surg,1997,63:1235-1242.
• [21]Iwaki T,Shimizu M,Mabuchi H.A case of pontaneous closure of coronary artery fistula with familial hypereholesterolaemia.Heart,2002,87:219.
• [22]Shubrcoks SJ Jr,Nagger CZ.Spontaneous near closure of coronary artery fistula.Circulation,l978,57:197-l99.
• [23]Behera SK,Danon S,Levi DS,et al.Transcatheter closure of coronary artery fistulaeusing the amplatzer duct occluder.Catheter Cardiovasc Interv,2006,68:242-248.