中老年人先天性冠状动脉瘘19例临床分析

The clinical analysis of diagnosis and treatment in 19 middle and aged patients with congenital coronary artery fistula

目的 总结我院中老年人先天性冠状动脉瘘的临床特点及治疗方法。 方法 对 19例先天性冠状动脉瘘患者病史、心电图、X线胸片、超声心动图、选择性冠状动脉造影和治疗方法及结果进行回顾性分析。 结果 17例经超声心动图检查 ,确诊 15例 ;12例行选择性冠状动脉造影均确诊 (其中包括超声心动图确诊的 8例 ) ;经导管弹簧圈栓堵治疗 5例 ,外科手术治疗 10例。随访 3个月至 7年均存活 ,无不适症状。 结论 先天性冠状动脉瘘一经确诊 ,应积极治疗 ,首选介入治疗 ,即经皮弹簧圈栓堵术 ,其方法可靠、创伤小、方便、有效、安全 ;其次可选择外科手术治疗 ,也是可靠、有效、安全的方法。

Objective To summarize the clinical features and therapeutic measurements in 19 patients with coronary artery fistula who were more than 40 years old. Methods Nineteen patients with coronary artery fistula by echocardiogram and/or selective coronary angiography were included. By asking their chest pain history, examining with electrocardiograph, X-ray chest film, echocardiograph and selective cardiograph, the effectiveness of the diagnosis and management of the disease was retrospectively analysed. Results Fifteen cases of coronary artery fistula were confirmed by echocardiography and 12 were confirmed by selective coronary artery angiography. The management by coil embolization in 5, surgical operation in 10. Follow-up for 3 months to 7 years showed that all patients survived and did not manifest symptoms. Conclusions All patients should be actively managed when coronary artery fistula was diagnosed. Transcatheter coil embolization is a safe, effective and reliable method with convenience and less resulting trauma. Surgical operation is the second choice due to the above advantages.