成人先天性冠状动脉瘘的临床及冠状动脉造影表现

发布时间：2018-02-24 08:13

本文关键词： 冠状动脉瘘成人先天临床冠状动脉造影　出处：《临床放射学杂志》2014年03期 　论文类型：期刊论文

【摘要】：目的探讨成人先天性冠状动脉瘘的临床表现及冠状动脉造影的影像特点。方法回顾分析2010年12月至2012年12月间32114例行冠状动脉造影成人患者中55例成人先天性冠状动脉瘘患者的临床表现及冠状动脉造影的影像表现。结果 55例先天性冠状动脉瘘患者,病程2天~20年不等。心前区疼痛30例,活动后胸闷、气短20例,背痛1例,心悸1例,晕厥1例;11例可闻及心前区杂音,44例无明显杂音;高血压29例,糖尿病12例,合并冠心病18例;冠状动脉造影显示瘘管起自左前降支31例,回旋支6例,右冠状动脉7例,同时起自左前降支及右冠状动脉11例;瘘管漏入肺动脉43例,冠状静脉窦1例,支气管动脉3例,右心房1例,右心室1例,左心房1例,左心室5例。多发瘘管共18例;瘘管扭曲41例,扩张20例,局限性狭窄9例;末端呈管状35例,呈丛状20例。结论成人先天性冠状动脉瘘临床表现复杂,无明显特异性表现,且易被其他心脏疾患所掩盖。冠状动脉造影是诊断本病的金标准,并能提供冠状动脉瘘的详细形态学及血流动力学信息。
[Abstract]:Objective to investigate the clinical manifestations of congenital coronary artery fistula in adults and the imaging features of coronary angiography. Methods from December 2010 to December 2012, 55 adult patients with congenital coronary arteriography were analyzed retrospectively. Results 55 cases of congenital coronary artery fistula, 55 cases of congenital coronary artery fistula, The course of disease ranged from 2 days to 20 years. There were 30 cases of anterior area pain, 20 cases of post-active chest tightness, 20 cases of shortness of breath, 1 case of back pain, 1 case of palpitation, 11 cases of syncope and 11 cases of syncope. Coronary angiography showed that fistula originated from left anterior descending branch in 31 cases, circumflex branch in 6 cases, right coronary artery in 7 cases, left anterior descending artery and right coronary artery in 11 cases, fistula leakage into pulmonary artery in 43 cases, coronary sinus in 1 case. Bronchial artery (n = 3), right atrium (n = 1), right ventricle (n = 1), left atrium (n = 1), left ventricle (n = 5), multiple fistula (n = 18), fistula distortion (n = 41), dilatation (n = 20), localized stenosis (n = 9), tubular end (n = 35). Conclusion the clinical manifestations of congenital coronary artery fistula in adults are complex, have no obvious specific manifestations, and are easily masked by other heart diseases. Coronary angiography is the golden standard for the diagnosis of this disease. It can provide detailed morphological and hemodynamic information of coronary artery fistula.
【作者单位】：首都医科大学附属北京安贞医院介入诊疗科;
【分类号】：R541.1;R814.43

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