小儿先天性冠状动脉瘘的临床诊断与分析

A study on congenital coronay artery fistula in children

目的 探讨先天性冠状动脉瘘的临床诊断特点。方法 回顾性分析有完整病史资料并经手术治疗的小儿先天性冠状动脉瘘 2 1例。结果 2 1例中右冠状动脉瘘 1 5例占 71 4 % ,左冠状动脉瘘 6例占 2 8 6% ,1 9例引流到右心系统占 90 5% ,2例引流到左心系统占 9 5% ;合并其他畸形 3例占 1 4 3 %。结论 先天性冠状动脉瘘最重要的临床诊断特征是心前区异常位置的连续性杂音 ,杂音的性质与分流部位、压力相关。彩色多普勒血流显像仪和升主动脉或冠状动脉造影能够明确诊断 ,可显示迂曲扩张的冠状血管与其引流的心腔部位。

Objective To investigate the clinical characteristics of congenital coronary artery fitula.Methods Twenty-one children of congenital coronary artery fistula with complete clinical information and operative results were retrospectively analyzed.Results The right coronary artery fistula was involved in 15 cases (71 4%);the left coronary fistula in 6 cases (28 6%).The fistula terminated in the right heart was found in 19(90.5%)and in the left heart side was involved in 2(9.5%).Three cases complicated other cardiovascular abnomalies.Conclusions The most important clinical characteristic is continuous pericardia murmurs.Which is related to location and pressure of shunting.Color Doppler echocardiography and aortography or coronary arteriography may provide the definite,diagnosis by which the tortuous and dilated coronary artery and chambers receiving the shunt can be showed.