成人先天性冠状动脉-肺动脉瘘18例临床分析

Congenital coronary pulmonary fistula in adults analysis of clinical date on 18 cases

目的 :探讨成人先天性冠状动脉 -肺动脉瘘的特点。方法 :回顾性总结分析 18例冠状动脉 -肺动脉瘘患者的冠状动脉造影及临床资料。结果 :4173例冠状动脉造影中检出冠状动脉 -肺动脉瘘 18例 ,检出率为 0 .43% ,其中单一瘘道 15例 ,双瘘道 3例 ,其分流量均较小 ;11例 ( 61.1% )患者的单支或多支冠状动脉伴有 5 0 %以上狭窄病变 ;临床随访患者无肺动脉高压和心力衰竭等重要并发症发生。结论 :分流量较大的冠状动脉 -肺动脉瘘在成年人群中非常少见 ,而大多数分流量较小的冠状动脉 -肺动脉瘘通常是在选择性冠状动脉造影时被偶然发现。

Objective:To study the characteristics of congenital coronary pulmonary fistula (CPF) seen in adulthood.Method:The clinical data and finding of coronary arteriography (CAG) were retrospectively reviewed in 18 patients(pts) with CPF(15 males and 3 female,aged 44 to 68 years).Result:①Among 4 173 pts undergone CAG,18 cases were found to have CPF, with an incidence of 0.43 %. Of them,15 cases had single shunt and 3 cases had two shunts between coronary artery and pulmonary artery,and all shunts were smaller.②Of them, 11 cases ( 61.1 %) were found to have over 50% stenosis lesions of one or more coronary arteries.③No major complications such as pulmonary hypertension and heart failure developed in this group.Conclusion:CPF with large shunts are rare in adults,most CPF with small shunts usually are discovered as incidental findings during CAG.