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Echocardiographic Evaluation of Coronary Artery Fistula in Pediatric Patients

机译：超声心动图评估小儿患者冠状动脉瘘

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摘要

The management of pediatric patients with coronary artery fistula (CAF) remains controversial because the clinical course of CAF may vary greatly from spontaneous closure to severe complications. The purpose of our study was to report the outcome of CAF in pediatric patients by using echocardiography as an evaluation tool. Between January 1997 and July 2003, 17 patients (age range, 5 months to 14 years; mean, 3.8 years) with coronary angiographically proven CAF were recruited. We divided patients into two groups. Group 1 (n = 4) included patients with symptoms related to CAF (n = 3), persistent coronary artery dilatation for 6 months (n = 4), and/or a continuous waveform of the fistula detected by Doppler (n = 3). Group 2 (n = 13) included patients who were asymptomatic, with normal coronary artery size or coronary artery dilatation less than 6 months, and/or a noncontinuous waveform of the fistula detected by Doppler. Group 1 patients received interventional therapy, whereas group 2 patients were managed conservatively. There were 6 male and 11 female patients. The correlation coefficient of coronary artery diameter measured on echocardiography and angiography was 0.935 and 0.834 in groups 1 and 2, respectively. The diameter of the involved coronary artery was 5.8-9.2 mm (mean, 7.50 ± 1.85) and 1.7-3.8 mm (mean, 2.72 ± 0.59) in group 1 and group 2, respectively. After transcatheter coil embolization, group 1 patients became asymptomatic with no residual fistula and had decrement of the coronary artery diameter (p = 0.035). All group 2 patients remained asymptomatic with no significant change in coronary artery size (p = 0.846) and 3 of them showed spontaneous closure of CAF. Persistent dilatation of the diameter of proximal coronary artery may be a useful parameter for determining subsequent application of interventional therapy. In patients with nonsignificant CAF, conservative follow-up is strongly suggested and intervention procedures may be unnecessary.
机译：小儿冠状动脉瘘（CAF）的治疗仍存在争议，因为从自发闭合到严重并发症，CAF的临床过程可能存在很大差异。我们研究的目的是通过使用超声心动图作为评估工具来报告小儿CAF的预后。在1997年1月至2003年7月之间，招募了17例冠状动脉造影证实的CAF（年龄范围5个月至14岁；平均3.8岁）。我们将患者分为两组。第1组（n = 4）包括以下症状的患者：CAF（n = 3），持续性冠状动脉扩张持续6个月（n = 4）和/或多普勒检测到的瘘管连续波形（n = 3） 。第2组（n = 13）包括无症状，冠状动脉正常大小或冠状动脉扩张少于6个月，和/或多普勒检测到的瘘管波形不连续的患者。第一组患者接受了介入治疗，而第二组患者接受了保守治疗。男6例，女11例。第1组和第2组经超声心动图和血管造影测得的冠状动脉直径的相关系数分别为0.935和0.834。第一组和第二组的受累冠状动脉直径分别为5.8-9.2 mm（平均7.50±1.85）和1.7-3.8 mm（平均2.72±0.59）。经导管线圈栓塞后，第1组患者无症状，无残余瘘管，冠状动脉直径减小（p = 0.035）。所有第2组患者均无症状，冠状动脉大小无明显变化（p = 0.846），其中3例显示CAF自发闭合。冠状动脉近端直径的持续扩张可能是确定介入治疗后续应用的有用参数。对于非显着性CAF的患者，强烈建议进行保守的随访，并且可能不需要干预程序。

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  • 来源
    《Pediatric Cardiology》 |2005年第6期|745-750|共6页
  • 作者

    C.-D. Liang; S.-F. Ko; C.-F. Huang; S.-C. Huang;

  • 作者单位

    Department of Pediatric Cardiology Chang Gung Children’s HospitalChang Gung University;

    Department of Radiology Chang Gung Children’s HospitalChang Gung University;

    Department of Pediatric Cardiology Chang Gung Children’s Hospital;

    Department of Pediatric Cardiology Chang Gung Children’s Hospital;

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  • 正文语种 eng
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  • 关键词

    Coronary artery fistula; Echocardiography; Angiography;

    机译：冠状动脉瘘;超声心动图;血管造影;

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