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An Unusual Huge Coronary Artery Aneurysm with Fistula

一例罕見之巨大冠狀動脈瘤合併廔管

摘要


接受心導管檢查的病患中約有0.15%到4.9%可發現有冠狀動脈瘤。而動脈粥狀硬化約佔50%成人冠狀動脈瘤之病因。我們報告一例64歲女性病患於右冠狀動脈合併有冠狀動脈瘤及廔管連接此動脈瘤及肺動脈,並有另一廔管連接左前降冠狀動脈近端及肺動脈,病患接受成功的冠狀動脈瘤切除及冠狀動脈廔管結紮手術。此病患因右冠狀動脈巨大之動脈瘤並壓迫到右心室血流出口處臨床上表現為喘氣及類似心絞痛之症狀,使得本案例值得注意。病患的症狀也在手術後完全緩解。

並列摘要


Coronary artery aneurysms are noted in 0.15% to 4.9% of patients undergoing coronary angiography. Atherosclerosis accounts for 50% of coronary aneurysms in adults. We report a 64-year-old female with a huge right coronary artery aneurysm with fistula connecting the aneurysm with the pulmonary artery and a fistula connecting the proximal left anterior descending artery with the pulmonary artery. Surgical resection of the coronary artery aneurysm and suture ligation of the coronary artery fistulas were performed. Pathological examination disclosed aneurysm with focal fibrosis and calcification. The patient presenting shortness of breath and angina-like symptoms caused by a huge right coronary artery aneurysm with compression of right ventricular outflow tract made this case noteworthy. The patient's symptoms resolved after surgical intervention.

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