The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Left main coronary artery dissection during the transcatheter coil closure of multiple congenital coronary fistulas

다발성 관상동맥누공의 코일 색전술 도중 발생한 좌주간부 관상동맥 박리

  • Lee, Hyung-Tak (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lim, Young-Hyo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Kang-Won (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Shin, Jin-Ho (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lim, Heon-Kil (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Jeong-Hyun (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Kyung-Soo (Department of Internal Medicine, Hanyang University College of Medicine)
  • 이형탁 (한양대학교 의과대학 내과학교실) ;
  • 임영효 (한양대학교 의과대학 내과학교실) ;
  • 이강원 (한양대학교 의과대학 내과학교실) ;
  • 신진호 (한양대학교 의과대학 내과학교실) ;
  • 임헌길 (한양대학교 의과대학 내과학교실) ;
  • 김정현 (한양대학교 의과대학 내과학교실) ;
  • 김경수 (한양대학교 의과대학 내과학교실)
  • Received : 2009.08.29
  • Accepted : 2009.11.16
  • Published : 2010.10.01
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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.

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.

Keywords

References

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