瘤化を伴う左冠状動脈主幹部-左房瘻に対し外科的治療を施行した1例

Left Main Coronary Artery-to-left Atrium Fistula with Aneurysmal Dilatation：Report of a Case

おわりに　冠状動脈瘻に対する外科的治療ではその病態や形態に応じて術式の選択はさまざまであり，個々に応じた対応が求められる．術前に造影CTやエコーなどで詳細に評価・検討することで，的確な治療の実施が可能となる．

Coronary artery fistula （CAF） is a relatively rare disease, many of which are asymptomatic and are not indicated for surgery. However, CAF’s patients with angina, heart failure due to shunt, and fistula hemangiomas are usually indicated for surgical treatment. A 49-year-old woman with severe congestive heart failure was found to have a fistula from the main trunk of the left coronary artery to the left atrium, and a fistula aneurysm. This patient had heart failure due to shunt blood flow, and also had a fistula aneurysm, so surgical treatment was indicated. During surgery, the fistula aneurysm was incised and the origin and opening of the fistula were closed without any problems. The postoperative course is good, and as of three years after the operation, the patient is being followed up at an outpatient clinic without recurrence of shunt flow and heart failure.