Wang Yanfei,Zhang Li,Huang Ping,et al.Therapies and mid-term follow-up of children with isolated coronary artery fistula[J].Journal of Clinical Pediatric Surgery,,19():54-58.[doi:10.3969/j.issn.1671-6353.2020.01.011]
Therapies and mid-term follow-up of children with isolated coronary artery fistula
- Keywords:
- Coronary Aneurysm; Treatment; Follow-up; Child
- CLC:
- R726;R732.2+1
- Abstract:
- Objective To explore the therapies and mid-term follow-ups of children with isolated coronary artery fistula (CAF).Methods From July 2009 to July 2017,the clinical data were retrospectively analyzed for 17 children of isolated CAF.There were 11 boys and 6 girls with a median age of 23 months (14 days to 12 years) and a median body weight of 11.3(3.8-29) kg.There were tachypnea (n=2),growth retardation (n=2) and recurrent respiratory infection (n=2).One child developed palpitation while another 10 cases remained asymptomatic.Heart murmurs existed in 14 cases.Fistulas originated from right coronary artery (n=8) and left coronary artery (n=9).Fistulas drained into right atrium (n=5),right ventricle (n=10) and left ventricle (n=2).Twelve patients were complicated by giant coronary artery aneurysms. Results The procedures included percutaneous CAF closure (n=1),fistula ligation without cardiopulmonary bypass (CPB) (n=1) and fistula correction with beating heart CPB (n=15).The mean hospitalization stay was (11.1±4.1) days.Two patients had a lower ejection fraction with a bottom of 38% within 3 days post-operation and returned to over 50% at 1 month.Transient T wave change occurred in 7 patients.A residual shunt with a size of 1 to 2 millimeters through fistula vanished recently in 2 cases.No perioperative mortality occurred.During a follow-up period of (10-108) months,all cases survived asymptomatically without any positive physical sign.Electrocardiogram showed no signs of myocardial ischemia while transthoracic echocardiography indicated normal cardiac function.The diameter of coronary arteries was smaller than preoperative counterparts. Conclusion Children with isolated CAF are mostly asymptomatic.However,its complication of giant coronary artery aneurysm requires early interventions for decent mid-term outcomes.However,long-term or lifelong follow-up is still essential due to dilated coronary artery.
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Memo
收稿日期:2019-02-20。
基金项目:广东省医学科研基金资助项目（编号：A2018018）
通讯作者:黄萍,Email:huangping999@126.com