Konjenital sağ ve sol koroner arter kaynaklı koroner-pulmoner arter fistülü

Ali Kemal GÜR; Ahmet KARAKURT; Yüksel KAYA

Article Details

Konjenital sağ ve sol koroner arter kaynaklı koroner-pulmoner arter fistülü

Authors:

Ali Kemal GÜR | Ahmet KARAKURT | Yüksel KAYA

Publisher:

Dicle University

Journal:

Dicle Medical Journal 2013 Vol.40 Issue 4, pp.659-662

Document Type:

Article

Publication Date:

11/2013

Document Language:

Turkish

Document ID (Org No.):

2000947688

Frequency:

Quarterly

eISSN:

1308-9889

pISSN:

1300-2945

Keywords:

Abstract:

 

Coronary artery fistula (CAF) is a rare congenital anomaly with an incidence of 1 in 50 000 live births. The fistula was observed at the right coronary artery in 53%, the left coronary artery in 42% and both coronary artery in 5% of the cases. Echocardiography examination in a 46 year-old woman with the symptoms of chest pain, palpitation and dyspnea revealed a severe mitral valve insufficiency and a moderate to severe tricuspid valve insufficiency. A CAF originating from the proximal part of the left anterior descending artery (LAD) and another fistula originating from osteal part of the right coronary artery (RCA) were detected by coronary angiography. Both fistulas were draining into the main pulmonary artery. The coronary artery fistula closed under cardiopulmonary by-pass. Mitral insufficiency originated from the posterior leaflet was diagnosed intra-operative exploration, and thereafter it was repaired with mitral annuloplasty including a quadrangular resection and use of a 32 No St Jude mitral ring. Tricuspid valve was repaired with Calangos Ring annuloplasty. Following six day hospital stay, the woman was discharged free of any symptom.

 

Koroner arter fistülü (CAF) , 50 000 canlı doğumda 1 görülen, nadir konjenital anomalidir. Fistül, vakaların %53 oranında sağ koroner arterde, %42 oranında sol koroner arterde ve %5 oranında iki koroner arterde görülmektedir. Göğüs ağrısı, çarpıntı ve nefes darlığı semptomlu 46 yaşında bayan hastanın ekokardiyografik muayenesinde, ileri mitral yetersizliği ve orta-ileri triküspid yetersizliği tespit edildi. Koroner anjiyografide, biri left anterior descending arter (LAD) proksimalinden ve diğeri right coronary artery (RCA) ostealinden kaynaklanan CAF tespit edildi. Her iki fistülde ana pulmoner artere drene olmaktaydı. CAF kardiyopulmoner bypass altında kapatıldı. İntra-operatif eksplorasyonda mitral kapaktaki yetersizliğin posterior leaflete ait olduğunu tespit edildi ve sonrasında quadrianguler rezeksiyon ve 32 No St Jude mitral halka kullanarak mitral annuloplasty yapıldı. Triküspid kapak Calangos Ring annuloplasty yapılarak tamir edildi. Her hangi bir semptomu olmayan hasta, altı gün hastanede takip edildikten sonra taburcu edildi.

Article Details

Konjenital sağ ve sol koroner arter kaynaklı koroner-pulmoner arter fistülü

Authors:

Ali Kemal GÜR | Ahmet KARAKURT | Yüksel KAYA

Publisher:

Dicle University

Journal:

Dicle Medical Journal 2013 Vol.40 Issue 4, pp.659-662

Document Type:

Article

Publication Date:

11/2013

Document Language:

Turkish

Document ID (Org No.):

2000947688

Frequency:

Quarterly

eISSN:

1308-9889

pISSN:

1300-2945

Dispne

çift arteriyovenöz fistül

mitral ve triküspit yetmezliği

Issues

Article Details

Konjenital sağ ve sol koroner arter kaynaklı koroner-pulmoner arter fistülü

Authors: Ali Kemal GÜR | Ahmet KARAKURT | Yüksel KAYA

Publisher: Dicle University

Journal: Dicle Medical Journal 2013 Vol.40 Issue 4, pp.659-662

Document Type: Article

Publication Date: 11/2013

Document Language: Turkish

Document ID (Org No.): 2000947688

Frequency: Quarterly

eISSN: 1308-9889

pISSN: 1300-2945

Dispne

çift arteriyovenöz fistül

mitral ve triküspit yetmezliği

Issues

Authors:

Ali Kemal GÜR | Ahmet KARAKURT | Yüksel KAYA

Publisher:

Dicle University

Journal:

Dicle Medical Journal 2013 Vol.40 Issue 4, pp.659-662

Document Type:

Article

Publication Date:

11/2013

Document Language:

Turkish

Document ID (Org No.):

2000947688

Frequency:

Quarterly

eISSN:

1308-9889

pISSN:

1300-2945