Videotoracoscopia para fechamento de fístula coronário-pulmonar: relato de caso

Abstract

The coronary artery fistulas (CAF) are rare and often found occasionally. The conventional treatment can be made by surgical closure with median thoracotomy or with embolization by catheterization. We describe an innovative technique to ligature of CAF, on a full endoscopy. Women, 45 years with symptomatic fistula between coronary artery anterior descending and trunk artery pulmonary, which took thoracoscopy left, pericardiotomy and ligation of fistula with metal clip without thoracotomy. There were no complications, stayed 24 hours in the ICU and was in hospital 4 days. The technique was effective, allows easy surgical accessibility and quick post-operative recovery.Descriptors: Arterio-arterial fistula, surgery. Pulmonary artery, pathology. Coronary vessel anomalies, surgery. Video-assisted surgery. Resumo As fístulas da artéria coronária (FAC) são raras e, muitas vezes, achado ocasional. O tratamento convencional é realizado por fechamento cirúrgico com toracotomia mediana ou por meio de embolização por procedimento hemodinâmico. Descrevemos uma técnica inovadora para ligadura da FAC de forma totalmente endoscópica. Mulher, 45 anos, com fístula sintomática entre artéria coronária descendente anterior e tronco de artéria pulmonar onde se realizou toracoscopia esquerda, pericardiotomia e ligadura do pertuito com clipe metálico. Não houve intercorrência, a paciente permaneceu 24 horas na UTI e teve alta hospitalar no 4º dia. A técnica foi efetiva, permitiu fácil acessibilidade cirúrgica e rápida recuperação pós-operatória.

Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature

“…As an alternative to surgery, bronchial artery embolisation is an established treatment modality for patients with haemoptysis [19, 35]. In some selected cases, a thorcoscopic approach for surgical ligation of CBFs, when technically amenable, may be considered an alternative to the percutaneous procedure [42]. In cases of severe CAD, coronary artery bypass graft with ligation of the fistula may be a better treatment.…”

Minimally invasive aortic valve replacement: an alternative to the conventional technique

“…Only in 2005 after the beginning of our experience [30][31][32] and Poffo et al studies, in 2006 [33], a new phase of minimally invasive cardiac surgery started in our environment, including video-assisted surgery, the intracardiac procedures through peripheral CPB, vacuum assistance and minithoracotomy.…”