Kemal UZUN, Denyan MANSUROĞLU, Erhan KAYA, Ulusoy Nilgün BOZBUĞA, Kaan KIRALİ, Hasan ARDAL, Vedat ERENTUĞ, Esat AKINCI, Cevat YAKUT, Bülent MUTLU

Konjenital koroner arter fistüllerinde cerrahi

Amaç: Konjenital koroner arter fistülleri koroner arter dolaşımının embriyolojik gelişimindeki bozukluk sonucu oluşan, ender görülen anomalilerdir. Materyal ve Metod: 1985 - 2002 tarihleri arasında kliniğimizde beşi erkek üçü kadın yaşlan 34-54 arasında olan 8 olguda koroner arter fistülü kardiyopulmoner bypass kullanılarak cerrahi olarak kapatıldı. Ek olarak olguların altısına koroner bypass operasyonu, ikisine ise kapak replasmanı uygulandı. Bulgular: Erken mortaliteye rastlanmadı. Koroner arter hastalığı ve ileri sol ventrikül disfonksiyonu olan hasta postoperatif 3. yılda kaybedildi. Yedi hastaya kontrol anjiyografi yapıldı. Olguların hiçbirinde rekkürrense rastlanmadı. Sonuç: Koroner arter fistüllü ekstrakardiyak veya sürür ile intrakardiyak kapatılması mortalite ve morbidite üzerine olumsuz etki oluşturmadan uygulanabilmektedir.

Surgical treatment of congenital coronary artery fistula

Background: Congenital coronary artery fistulas are rare congenital anomalies developing from embriological malformation of coronary circulation. Methods: Between 1985 and 2002, five male and three female, eight cases underwent surgical closure of the congenital coronary artery fistula with the aid of cardiopulmonary bypass. Additional coronary artery bypass grafting (in six cases) and valve replacement procedures (in two cases) were performed. Results: There was no operative mortality. One patient with coronary disease and severe left ventricular dysfunction died three years later postoperatively. Control angiography was performed in seven patients. Recurrence was not detected in any patients. Conclusion: We advocate that coronary artery fistula can be operated by either extracardiac or intracardiac approaches without mortality and morbidity.

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