Case Report: Surgical Treatment of High-Flow Coronary Fistulas for the Pulmonary Artery

Abstract Coronary fistulas are rare anomalies that can affect approximately 1% of the population, presenting few specific symptoms, and are often found occasionally in coronary angiography. Here we describe the case of a 61-year-old patient with complaints of precordialgia and dyspnea since adolescence, with late diagnosis of coronary fistulas with drainage to the pulmonary artery, and with unsuccessful percutaneous treatment. Therefore, she underwent open surgery for the correction of the already known fistulas, in addition to the hemangioma involving such vessels, which made the understanding and resolution of this case more complex.

摘要：冠状动脉瘘（Coronary fistulas）是一类罕见心血管畸形，人群发病率约为1%，临床表现缺乏特异性，多在冠状动脉造影检查中偶然被检出。本文报告1例61岁患者的诊疗经过：该患者自青少年时期起便反复出现心前区疼痛与呼吸困难症状，直至后期才被确诊为肺动脉引流型冠状动脉瘘，且经皮介入治疗未能成功。为此，患者接受开放手术以矫治已明确的冠状动脉瘘，同时一并切除累及相关血管的血管瘤；该合并症进一步提升了本例病例的诊疗复杂性。