Coronary arterial fistulas

Published on Dec 21, 2006in Orphanet Journal of Rare Diseases3.523
· DOI :10.1186/1750-1172-1-51
Shakeel A. Qureshi51
Estimated H-index: 51
(Boston Children's Hospital)
Sources
Abstract
A coronary arterial fistula is a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. This is a rare defect and usually occurs in isolation. Its exact incidence is unknown. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. They do not usually cause symptoms or complications in the first two decades, especially when small. After this age, the frequency of both symptoms and complications increases. Complications include 'steal' from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrillation, rupture, endocarditis/endarteritis and arrhythmias. Thrombosis within the fistula is rare but may cause acute myocardial infarction, paroxysmal atrial fibrillation and ventricular arrhythmias. Spontaneous rupture of the aneurysmal fistula causing haemopericardium has also been reported. The main differential diagnosis is patent arterial duct, although other congenital arteriovenous shunts need to be excluded. Whilst two-dimensional echocardiography helps to differentiate between the different shunts, coronary angiography is the main diagnostic tool for the delineation of the anatomy. Surgery was the traditional method of treatment but nowadays catheter closure is recommended using a variety of closure devices, such as coils, or other devices. With the catheter technique, the results are excellent with infrequent complications.
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冠的动脉管(CAF ) ,先天的心疾病的一种不平常的形式,被在一根冠的动脉和一个心脏的房间或容器之间的反常通讯描绘。这疾病经常在无征状的个人顺便说一下被发现,并且导致心脏的失败,心肌的局部缺血和咽峡炎,易传染的心内膜炎,和心在以后的生命破裂。外科的修理和 transcatheter 闭合在 CAF 的处理有效、安全,但是 CAF 的经皮的管理能排除中部的 sternotomy 并且心肺绕过,并且可以有有 transcatheter embolization 技术的更少的病态,包括 occluders ormicrocoils 的使用。我们用专利管 occluder 向正确的室从左冠的动脉汇报巨大的 CAF 的成功的经皮的闭合。
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