在冠状动脉旁路移植术中修复双侧冠状动脉-肺动脉瘘

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摘要

冠状动脉-肺动脉瘘(CPAF)是一种罕见的疾病,可导致严重的左向右分流,并使常规冠状动脉旁路移植手术复杂化。目前还没有最佳实践指南,也很少有关于同时治疗冠状动脉疾病的 CPAF 的报道。我们介绍了一例双侧 CPAF 病例,患者是一名 60 岁的男性,伴有无症状冠状动脉疾病,经冠状动脉搭桥、心外膜结扎和补片重建的跨肺闭合 CPAF 治疗后获得成功。该病例强调了最佳心肌保护和完全关闭瘘管对预防冠状动脉盗血风险的重要性。
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Repairing Bilateral Coronary-Pulmonary Artery Fistulas During Coronary Artery Bypass Grafting

Coronary-pulmonary artery fistulas (CPAFs) are rare entities that can cause significant left-to-right shunting and complicate routine coronary artery bypass grafting. There are no best practice guidelines and a scarcity of reports regarding concomitant treatment of CPAF with coronary artery disease. We present a case of bilateral CPAFs in a 60-year-old man with symptomatic coronary artery disease treated successfully with coronary artery bypass, epicardial ligation, and transpulmonary closure of CPAF with patch reconstruction. This case highlights the importance of optimal myocardial protection and complete closure of the fistula to prevent risk of coronary steal.

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