| Purpose: To evaluate the clinical efficacy and safety of percutaneous coronary intervention for congenital coronary artery fistula.Method: In the period from March 2012 to March 2016 in Yanan Hospital Affiliated to Kunming Medical University Department of Cardiology of coronary artery fistula and transcatheter closure in patients with a total of 105 cases,including 65 cases of male, female 40 cases. By using percutaneous coil or occluder for immediate coronary angiography blocking effect and after January, March, June, December, follow-up(clinical symptoms, coronary angiography, echocardiography), analysis and evaluation of the data for objective statistics.Results:Coronary angiography showed that 105 cases of patients with congenital coronary artery fistula 150, 105 patients with single congenital coronary artery fistula was most common in 63 cases (60%), two coronary artery fistula in 40 cases (38.10%), 2 cases of three coronary artery fistula (1.90%) classification. According to the diversion of congenital coronary artery fistula: different right coronary artery and pulmonary artery in 63 (42%); the left anterior descending coronary artery pulmonary artery fistula in 70 (46.67%); the left anterior descending coronary artery - left atrial fistula in 10 (6.67%); left circumflex coronary artery Pulmonary artery fistula in 5 (3.33%);the left circumflex coronary artery - left atrial fistula in 1 (0.67%); the right coronary artery right ventricle fistula in 1 (0.67%). On the basis of congenital coronary artery fistula size classification,including 2 cases of patients with giant congenital coronary artery fistula,1 cases of use patent ductus arteriosus occluder (PDA occluder),1 cases with ventricular septal defect occluder (VSD occluder closure), the remaining 103 patients were using spring coil occlusion successfully, no occluder or spring ring off.After 15 minutes of coronary angiography showed 75 cases of patients with no residual shunt closure (7 1.43%), 30 cases of residual shunt (28.57%), including 50 cases of postoperative June coronary angiography showed 4 cases of residual shunt, 4 cases of residual shunt in 2 patients to surgery underwent surgical treatment, 2 cases were followed up regularly.22 cases (including 2 cases of patients with postoperative residual shunt) December coronary angiography showed no obvious shunt.2 patients with hemolysis, the drug recovered after the treatment of.2 positive cases of arteriovenous fistula puncture, improved after treatment, no other serious complications, all patients had no obvious malignant arrhythmia, acute myocardial infarction, coronary artery dissection, occluder Off, ectopic embolism formation,damaged heart valves, infective endocarditis and other serious postoperative complications. The average hospitalization days of 11.9 days, the average cost of 34 thousand and 580 yuan. 103 cases with intraoperative coil were (98.10%), 2 cases(1.90%),who occluder angiography of coronary artery fistula in diameter (8.59 + 5,18)mm and CT measurement of preoperative coronary artery diameter (6.78 + 1.2)compared to the mm, there was no significant difference (P>0.05); 75 patients were compared before surgery, after surgery in January, March, June, echocardiography and cardiac chambers large Small left atrium before operation (32.78 + 5.08) mm,after June reduced to (31.61 + 4.09) mm (P<0.05); preoperative left ventricular (49.14+ 5.05) mm, after June reduced to (44.79 + 5.28) mm; right ventricular before operation (19.78 + 3.55) mm, postoperative in June down to (18.27 + 2.26) mm after operation decreased significantly, the difference was statistically significant (P<0.05).Conclusion:Percutaneous coronary intervention is a very effective,safe and minimally invasive procedure for congenital coronary artery fistula. It is less time-consuming, highly successful, less invasive, quicker to recover, and relatively innovative... |
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