Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Evaluation of Coronary Artery Fistula

관상동맥루의 임상적 고찰

  • Lee Sak (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Park Han-Ki (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Lim Sang-Hyun (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Hong You-Sun (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Chang Byung-Chul (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Kang Meyun-Shick (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Cho Bum-Koo (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine) ;
  • Park Young-Hwan (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine)
  • 이삭 (연세대학교 의과대학 흉부외과학교실) ;
  • 박한기 (연세대학교 의과대학 흉부외과학교실) ;
  • 임상현 (연세대학교 의과대학 흉부외과학교실) ;
  • 홍유선 (연세대학교 의과대학 흉부외과학교실) ;
  • 장병철 (연세대학교 의과대학 흉부외과학교실) ;
  • 강면식 (연세대학교 의과대학 흉부외과학교실) ;
  • 조범구 (연세대학교 의과대학 흉부외과학교실) ;
  • 박영환 (연세대학교 의과대학 흉부외과학교실)
  • Published : 2005.10.01
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Abstract

Background: Coronary artery fistula is rare congenital anomaly, which account for $0.27\~0.40\%$ of all congenital heart diseases. We report the clinical observations of 45 patients with coronary artery fistula. Material and Method: We reviewed all patients presented with or without symptoms of coronary artery fistula between 1987 and 2004. Age ranged from 1 to 83 years. Twenty-six patients were female. The patients were divided into 2 groups according to the presenting symptoms. Twelve patients were in group A (asymptomatic) and 33 patients in group B (symptomatic). The most common clinical presentation in group B was angina (18) followed by dyspnea (7), atypical chest pain (5), syncope (1), fatigue (1), and palpitation (1). Twenty-five patients were associated with other cardiac diseases, which were atrial septal defect (4), coronary artery occlusive disease (6), hypertension (12), and valvular heart disease (2). Result: Patients were followed-up for a mean period of $64.8\pm62.7$ months. There was no complication related to coronary artery fistula during the follow-up period in both group. There was no mortality related to coronary artery fistula. Conclusion: In symptomatic patients, early surgical treatment is recommended considering the low perioperative morbidity. In asymptomatic patients receiving medical treatment, close follow up may be necessary.

배경: 관상동맥루는 모든 선천성 심질환의 $0.27\~0.40\%$를 차지하는 매우 드문 선천성 기형으로 알려져 있다. 저자들은 45명의 관상동맥루 환자들을 대상으로 임상결과를 살펴보았다. 대상 및 방법 : 1987년부터 2004년까지 본원에서 증상의 유무와 관계없이 관상동맥루를 진단받은 모든 환자들을 대상으로 하였다. 나이는 1세부터 83세까지의 분포를 보였고, 여자가 26명이었다. 환자들을 증상의 유무에 따라 두 군으로 나누었다. 12명의 환자에서는 증상이 없이 우연히 발견된 경우로 A군으로 분류되었으며, 33명의 환자는 증상이 있는 군으로 B군으로 분류되었다. B군에서 가장 흔한 증상은 흉통(18) 이었고, 그 외에 호흡곤란(7), 비전형적 흉통(5), 실신(1), 피로감(1), 심계항진(1) 등이 있었다. 25명의 환자에서는 다른 심혈관질환이 동반되었는데, 심방중격결손증(4), 관상동맥협착증(6), 고혈압(12), 심장판막질환(2) 등이 있었다. 걸과: 평균 추적관찰 기간은 $64.8\pm62.7$개월이었다. 추적관찰기간 동안 두 군 모두에서 관상동맥루 관련 합병증은 없었다. 또한 관상동맥루 관련 사망 역시 두 군 모두에서 한 예도 없었다. 결론: 수술전후의 사망률이 낮은 것을 고려해 볼 때 증상이 있는 환자들에서는 조기에 수술적 교정을 시행하는 것이 바람직할 것으로 생각된다. 무증상으로 약물치료를 시행하는 환자들에서는 집중적인 추적관찰이 필요할 것으로 생각된다.

Keywords

References

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