冠狀動脈瘻管併發動脈瘤生成

Coronary Artery Fistula with Aneurysm Formation

冠狀動脈瘻管是種罕見的先天性冠狀動脈異常，大多數的冠狀動脈瘻管是經由心臟影像學檢查偶然診斷出來的。小的瘻管可能沒有症狀，然而大的瘻管會造成心絞痛、心肌缺氧、甚至致命的併發症。由於心導管器械和技術的進步，冠狀動脈瘻管可以藉由經皮途徑關閉，同時也比傳統結紮手術侵入性更小。電腦斷層冠狀動脈攝影是非侵入性的檢查，可用來偵測冠狀動脈瘻管，術前可以評估冠狀動脈的型態，術後可以追蹤治療的成果，並且評估是否發生再通的現象。

Coronary artery fistulas are a rare congenital coronary anomaly. Most of them are diagnosed incidentally by cardiac image study. Small fistulas are asymptomatic, while large fistulas may cause angina, myocardial ischemia, and fatal complications. Due to the improvement in equipment and technique, coronary artery fistulas could be closed by percutaneous approach, which is less invasive than traditional surgical ligation. The computed tomographic coronary angiography is a noninvasive test to detect and characterize coronary artery fistulas, and is also useful to evaluate the result after treatment and to detect recanalization.