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An interesting case of coronary artery fistula: diagonal artery-, left circumflex artery-and right coronary artery to left ventricle fistulas/Ilginc bir koroner arter fistulu olgusu: diyagonal arter, sirkumfleks arter ve sag koroner arter ile sol ventrikul arasinda fistuller.

Ilk kez 1865 yilinda Krauze tarafindan tanimlanan ve sikligi %0.13 olarak bildirilen koroner arter fistbileri, koroner arterler ile kalp bosluklan, buyuk damarlar (pulmoner arter, bronsiyal arter) veya diger vaskuler yapilar (mediyastinal damarlar, koroner sinbs) arasindaki anormal baglantilardir.

Koroner arter fistullerinin yaklasik %50'sinin sag koroner arterden, %42'sinin sol koroner arterden, %5'inin her iki koroner arterden kaynaklandigi, en sik sag ventrikule (%41), sag atriyuma (%26) ve pulmoner artere (%17), seyrek olarak da koroner sinbse (%7), sol atriyuma (%5) ve sol ventrikble (%3) acildigi bildirilmistir. Yaptigimiz literatur taramasinda ayni hastada uc koroner arterden sol ventrikule fistul hic bildirilmemistir.

Hipertansiyon ve diyabetes mellitus nedeni He takipte olan 76 yasinda bayan hasta, stabil angina pektoris nedeniyle klinigimize basvurdu. Fizik muayenede arteryel kan basinci 130/80 mm Hg, nabiz sayisi 72 atim/dakika, duzenli idi. Apekste ve sol 3.-4. interkostal aralikta 2/6 siddetinde devamh ufurum tespit edildi. Diger sistem muayenelerinde anormal bir bulguya rastlanmadi. Laboratuvar degerlerinde, telekardiyografide ve ekokardiyografide anormal bulgu saptanmadi. Elektrokardiyografide sinus ritmi, V 4-6 derivasyonlarinda ST depresyonu izlendi. Efor testi pozitif bulunmasi uzerine yapilan koroner anjiyografide diyagonal arter (Sekil 1), sirkumfleks arter (Sekil 2) ve sag koroner arter (Sekil 3, Video 1. Video/hareketli goruntuler www.anakarder.com'da izlenebilir) ile sol ventrikul arasinda fistul oldugu tespit edildi. Hastaya ileri yas nedeni medikal takip karan alindi.

[ILLUSTRATIONS OMITTED]

Yasin Turker, Selahattin Akcay, Mehmet Ozaydin Suleyman Demirel Universitesi Tip Fakultesi, Kardiyoloji Ana Bilim Dah, Isparta, Turkiye

Yazisma Adresi/Address for Correspondence: Yasin Turker

Hizirbey M. 1519 S. No: 9 D: 3 32100 Isparta 32100 Isparta, Turkiye

Tel: 0246 232 95 03/1125 Mobile: 0505 654 6169 E-posta: dryasinturker@hotmail.com
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Title Annotation:E-page Original Images/E-sayfa Orijinal Goruntuler
Author:Turker, Yasin; Akcay, Selahattin; Ozaydin, Mehmet
Publication:The Anatolian Journal of Cardiology (Anadolu Kardiyoloji Dergisi)
Article Type:Brief article
Geographic Code:7TURK
Date:Apr 1, 2008
Words:268
Previous Article:Statin use is associated with decreased CD-40 ligand expression on T lymphocytes of coronary atheroma plaque in patients with stable coronary artery...
Next Article:A case of coronary artery aneurysm resulted in sudden death/Ani olumle sonuclanan bir koroner arter anevrizmasi olgusu.
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