8例冠状动脉异常临床治疗

目的总结冠状动脉异常的临床治疗经验.方法 8例冠状动脉异常患者中冠状动脉瘘5例,冠状动脉起源异常2例,冠状动脉瘤1例.合并室间隔缺损1例,瓣膜性心脏病1例,冠状动脉粥样硬化性心脏病1例.右冠状动脉瘘均在心肺转流术下经心腔修补内瘘口或经扩张的冠状动脉修补外瘘口,或同时修补内、外瘘口;左冠状动脉-肺动脉瘘行瘘支动脉结扎术或在心肺转流术心脏不停跳下经肺动脉修补.左冠状动脉起源于肺动脉畸形,1例行左冠状动脉根部结扎 冠状动脉旁路移植术,1例行肺动脉内隧道术,冠状动脉瘤1例合并远端冠状动脉狭窄,切除冠状动脉瘤并行冠状动脉旁路移植术.合并的心脏疾病均同时治疗.结果本组无手术死亡,术后心脏杂音均消失,8例术后症状均缓解.结论手术治疗对于冠状动脉异常患者是一种行之有效的手段.

Clinical Treatment for 8 Cases with Coronary Artery Anomalies

Objective To study clinical experience for coronary artery anomalies. Methods Eight patients were diagnosed coronary artery anomalies, including 5 cases for coronary artery fistula, 2 cases for anomalous origin and 1 cases for coronary artery aneurysm. Complication include VSD for 1 case, Valve heart decease for 1 case and 1 case CAD. Right coronary fistula were closed inside the ventricle or from the enlarged coronary artery on CPB. Left coronary artery-pulmonary artery fistula were treated by digation the fistula or closing from pulmonary artery on CPB. Anomalous origin from pulmonary artery of LCA were treated by CABG or inside tunnel, CAA combined with distal stenosis was treated by aneurysm dissection and CABG. Results No death was found and cardiac murmur all disappeared, cardiac function were improved on 8 patients. Conclusion Surgery deployment is effective for coronary artery anomalies.