9例先天性冠状动脉瘘的外科治疗研究.pdfVIP

浙江大学硕士学位论文 9例先天性冠状动脉瘘的外科治疗 浙江大学医学院 外科学 2002 级硕士研究生 鲁高锋 导师 余国伟 主任医师 [摘要] 目的 总结9 例先天性冠状动脉瘘的外科治疗效果。 方法 2003 年至今，应用超声心动图，升主动脉造影及选择性冠状动脉造影检查 确诊CAF9 例，其中男6 例，女3 例；年龄 13－56 岁。7 例为单纯得先天性冠 状动脉瘘，2 例合并有其它心脏外科疾病。9 例中，右冠状动脉瘘有6 例，左冠 状动脉瘘3 例。 结果 手术均在体外循环下进行。6 例经冠状动脉闭合瘘口，2 例经心腔闭合瘘 口；1 例合并其它心脏病变同期矫治。心腔内发现二个瘘口者1 例，余为单一瘘 口。全组无死亡及残余漏。9 例平均随访1 年，均无症状。一例有ST-T 改变。 结论 外科治疗先天性冠状动脉瘘是安全和有效的方法。合并有其他心脏外科疾 病应同时矫治。准确判断瘘口的位置和确切可靠得缝合技术是防止残余漏的关 键。 [关键词] 心脏缺损，先天性，心脏外科手术 [Abstract] [Purpose] summary the surgical therapy efficacy of nine Congential coronary artery fistula(CAF) [Method] since 2003 up to now, use UCG,AO angiography and Selective coronary arteriography diagnosised CAF 9 cases,(male 6 cases, female 3cases);age between 13 to 56 years.7 cases are simple CAF,2 cases combined other cardiac surgery diseases; in the 9 cases ,there have 6 cases of right CAF and 3 cases of left CAF. [Result] all operations are under extracorporeal circulation. 6 cases closed fistulae through CA,2 cases closed fistulae through chambers heart,1 case bombine other cardiac surgery diseases do synchronization therapy.1 case have 2 orificium fistulaes in chambers heart,other cases only 1 浙江大学硕士学位论文 have 1 orificium fistulae.After operation ,there hase no death and residued leak. Average time of lollow-up-visit of 9 cases is 1 year, all cases is absence of symptos.1 case hase ST-T change. [Conclusion] Surgical theapy of CAF is the safety and effective method. CAF combine other cardiac surgery diseases should do synchronization therapy. Accurate judgement