다발성 관상동맥누공의 코일 색전술 도중 발생한 좌주간부 관상동맥 박리
Left main coronary artery dissection during the transcatheter coil closure of multiple congenital coronary fistulas
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관상동맥누공은 희귀한 질환으로 대부분은 증상이 없지만 드물게 관상동맥 ‘steal’에 의한 증상을 보이게 된다. 관상동맥누공의 치료로는 수술적 치료와 심도자를 이용한 선택적인 색전술이 있는데 심도자를 이용한 색전술도 수술과 동일한 수준의 효과가 있음이 보고되고 있다. 한편, 의인성 좌주간부 관상동맥 박리는 드물고도 매우 치명적인 합병증이다. 이번 증례에서 우리는 심도자를 이용한 관상동맥누공의 코일 색전술 도중 좌주간부 관상동맥 박리를 경험하고 치료한 드문 경험을 하였기에 이를 보고한다.
Abstract
A congenital coronary fistula is a rare defect. Many congenital fistulas drain into the pulmonary artery and may be an incidental finding; however, some fistulas can cause a coronary ‘steal’ phenomenon resulting in angina. The transcatheter closure of coronary fistulas is an accepted, effective, and safe alternative to surgery in adults. In comparison, left main coronary artery (LMCA) dissection is rare and can lead to life-threatening complications during percutaneous coronary intervention. The optimal treatment for patients with LMCA dissection during catheter-based procedures is uncertain. Some studies suggest that bail-out LMCA stenting provides good acute and long-term results. Here, we present a case of LMCA dissection during the transcatheter coil closure of multiple congenital coronary fistulas with subsequent successful stent implantation in the LMCA.
참고문헌 (15)
- Olearchyk AS, "Congenital bilateral coronary-to-pulmonary artery fistulas", Ann Thorac Surg, 64, pp.233~235 (1997)
- Vavuranakis M, "Coronary artery fistula in adults: incidence, angiographic characteristics, natural history", Cathet Cardiovasc Diagn, 35, pp.116~120 (1995)
- Kiuchi K, "Left coronary artery-left ventricular fistula with acute myocardial infarction, representing the coronary steal phenomenon: a case report", J Cardiol, 34, pp.279~284 (1999)
- Arani DT, "Coronary artery fistulas emptying into left heart chamber", Am Heart J, 96, pp.438~443 (1978)
- Bauer HH, "Congenital coronary arteriovenous fistula: spontaneous rupture and cardiac tamponade", Ann Thorac Surg, 62, pp.1521~1523 (1996)
- Cho JS, "A case of percutaneous transcatheter coil embolization for congenital coronary arterioventricular fistula", Korean Circ J, 27, pp.927~932 (1997)
- Cason BA, "Coronary steal caused by a coronary artery fistula", J Cardiothorac Vasc Anesth, 6, pp.65~67 (1992)
- Cheng TO, "Management of coronary artery fistulas: percutaneous transcatheter embolization versus surgical closure", Catheter Cardiovasc Interv, 46, pp.151~152 (1999)
- 이세환, "관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과", 대한내과학회지, 66(6), pp.571~575 (2004), 대한내과학회
- Chin B, "Unstable angina following acute MI in a patient with bilateral coronary artery fistulae", Int J Clin Pract, 55, pp.342~343 (2001)
- Baue AE, "A later stage of anomalous coronary circulation with origin of the left coronary artery from the pulmonary artery: coronary artery steal", Circulation, 36, pp.878~885 (1967)
- Mavroudis C, "Coronary artery fistulas in infants and children: a surgical review and discussion of coil embolization", Ann Thorac Surg, 63, pp.1235~1242 (1997)
- 김준영, "요골동맥을 이용한 진단적 관상동맥 조영술중 발생한 좌주간부 관상동맥 박리증 1예", 대한내과학회지, 72, pp.S186~S190 (2007)
- Capdeville M, "Emergency off-pump coronary artery bypass grafting for acute left main coronary artery dissection", Tex Heart Inst J, 28, pp.208~211 (2001)
- Cheng CI, "Percutaneous coronary intervention for iatrogenic left main coronary artery dissection", Int J Cardiol, 126, pp.177~182 (2008)