cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2022.5.n1901cardio-1901Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESРаспространенность и характеристики фистулы коронарной артерии у взрослых: анализ результатов коронароангиографии 18 106 пациентовPrevalence and characteristics of coronary artery fistula in adults: coronary angiographic analysis of 18,106 patientshttps://orcid.org/0000-0002-6010-1319Текели СенгулСебахатTekeli SengulSebahat

MD

отделение кардиологии, 06230, Анкара, Турция

MD

Cardiology Department, Ankara, Turkey

dr.sebahattekeli@gmail.comhttps://orcid.org/0000-0001-7084-0038КарасуБетул БануKarasuBetul Banu

MD

Отделение кардиологии, 06790, Анкара, Турция

 MD

Cardiology Department, Ankara, Turkey

benginoglu@yahoo.comНаучно-образовательная больница АнкарыТурцияAnkara Research and Educational HospitalTurkeyГосударственная больница Этимесгут Сехит Саит ЭртюркТурцияEtimesgut Sehit Sait Erturk State HospitalTurkey2022310520226256266Copyright © Kardiomag, 20222022KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1901

Цель    Фистула коронарной артерии (ФКА) — редко встречающаяся патология, характеризующаяся аномальным соединением коронарной артерии с камерой сердца или крупным грудным сосудом. Заболеваемость ФКА точно не установлена из-за большого количества невыявленных случаев. Кроме того ФКА демонстрирует неоднородность своей анатомической конфигурации и клинических последствий. Мы стремились оценить частоту, результаты визуализации и клинические особенности ФКА среди пациентов в нашем специализированном медицинском центре.Материал и методы    Ретроспективно проанализированы ангиографические данные 18 106 взрослых пациентов, которым была проведена коронароангиография в период с января 2011 г. по июнь 2013 г.Результаты    ФКА была выявлена у 22 пациентов (0,14%). Из них у 5 пациентов фистула была двусторонней (23%). 65% фистул исходили из передней нисходящей коронарной артерии и 53% дренировались в легочную артерию. Левый желудочек и левое предсердие были единственными местами дренирования левосторонних коронарных фистул. У одного пациента с ФКА развился инфаркт миокарда без подъема сегмента ST при отсутствии явного тромбоза.Вывод    В отличие от предыдущих данных, в этом исследовании чаще встречались двусторонние ФКА. Вопреки большинству литературных данных, более половины ФКА исходят из передней нисходящей коронарной артерии и в большинстве случаев дренируются в легочную артерию. Выявлены также редкие анатомические типы ФКА.

Aim    Coronary artery fistula (CAF) is a rarely encountered anomaly that is characterized by an abnormal connection between a coronary artery and a cardiac chamber or a great thoracic vessel. Its incidence has not been precisely established due to the large number of undiagnosed cases and it shows heterogeneity in its anatomic configuration and clinical consequences. We aimed to assess the frequency, imaging findings, and clinical features of CAF among patients in our tertiary medical center.Material and methods    The angiographic data of 18,106 consecutive adult patients who underwent coronary angiography between January 2011 and June 2013 were retrospectively analyzed.Results    CAF was detected in 22 patients (0.14 %). Of these, 5 patients had bilateral fistulas (23 %). 65 % of the fistulas originated from the left anterior descending coronary artery,and 53 % drained into the pulmonary artery. The left ventricle and left atrium were the only drainage sites for left-sided coronary artery fistulas. One patient with a CAF presented with non-ST elevated myocardial infarction in the absence of an evident thrombosis.Conclusion    Unlike previous reports, bilateral CAFs were more commonly encountered in this study. Contrary to most of the data in the literature, more than half of the CAFs originated from the left anterior descending coronary artery and most drained into the pulmonary artery. Rare anatomic types of CAFs were also detected.

 

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The authors declare that there are no conflicts of interest present.