Coronary Artery Fistulas: Case Series and Literature Review.

Published on Jan 12, 2017in The Cardiology
· DOI :10.1159/000447445
Christina Karazisi2
Estimated H-index: 2
(Sahlgrenska University Hospital),
Peter Eriksson30
Estimated H-index: 30
+ 0 AuthorsMikael Dellborg52
Estimated H-index: 52
Sources
Abstract
Congenital coronary artery fistulas are rare anomalies. As coronary angiography and multidetector computed tomography have become more accessible, they have been increasingly used in the investigation of chest pain and heart failure. Coronary artery fistulas are often an incidental finding, which raises the question of how patients with this condition should be managed. Intervention with either transcatheter closure or surgical closure is often technically possible. Many patients are asymptomatic early after closure. However, follow-up studies have shown post-closure sequelae, such as residual leakage, thrombosis with or without myocardial infarction, and coronary stenosis. Therefore, there has been a shift from intervention towards watchful waiting in asymptomatic patients. In this article, we review the published literature on the natural history and treatment outcomes in individuals with coronary artery fistulas. We present case reports from our clinic and discuss the management of incidental findings of coronary artery fistulas.
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#2Weidong Ren (PRC: China Medical University (PRC))H-Index: 7
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#2Ashley St. Germain (St. George's University)H-Index: 1
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Abstract Coronary arterial fistulas are abnormal connections between the coronary arteries and the chambers of the heart or major thoracic vessels. Although first described in 1841, the true incidence is difficult to evaluate because approximately half of the cases may be asymptomatic and clinically undetectable. This review will discuss the history and prevalence of coronary artery fistulas and their morphology, histology, presentation, diagnosis, treatment options, and complications.
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#1Bhavesh ThakkarH-Index: 6
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#2Juan CarreteroH-Index: 7
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We present a case of congenital multiple coronary artery–left ventricle micro-fistulas, which were treated with propranolol disappearing within 6 months. She had a malformative syndrome associated with a chromosomal abnormality. The treatment for coronary artery fistula includes surgical ligation and transcatheter closure, but they are not indicated in congenital micro-fistulas. We propose propranolol as a treatment in this type of diffuse fistula.
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#1Imthiaz Manoly (University of Manchester)H-Index: 5
#2Vaikom S. Mahadevan (University of Manchester)H-Index: 17
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Coronary-cameral fistula is an abnormal fistulous communication between a coronary artery and a cardiac chamber. Significant fistulae require closure either percutaneously or surgically to avoid any complications. We describe the case of a 19-year-old male patient with tetralogy of Fallot, who presented with a complex coronary-cameral fistula, which precluded percutaneous occlusion. By means of a hybrid approach, the fistula was easily located and closed surgically. Where surgical correction of ...
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Background Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral CPFs, the value of a multidetector computed tomography (MDCT) imaging technique as an adjuvant to coronary angiography (CAG) is eminent. The purpose of this study was to describe the clinical presentation, diagnostic modalities, and management of coincidentally detected congenital CPFs. Hypothesis Unilateral and multilateral coronary-pulmonary fistu...
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OBJECTIVE. The purpose of this article is to describe the evaluation of congenital coronary artery fistulas (CAFs) with MDCT angiography with ECG gating (MDCTA), including the clinical manifestations, scanning techniques, differential diagnosis, and other imaging methods that may be used. CONCLUSION. Congenital CAFs are rare coronary artery anomalies of termination. MDCTA is a first-line modality for pretreatment planning, and imaging findings should be recognized because CAFs may be detected in...
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#1Jae Jung Lim (Catholic University of Korea)H-Index: 1
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OBJECTIVE. The prevalence of coronary artery fistula (CAF) based on coronary angiographic findings has been reported. However, the number of incidentally found CAFs is increasing as coronary CT angiography (CTA) has become popular. The purpose of this study was to determine the prevalence and types of CAFs detected with coronary CTA. MATERIALS AND METHODS. Between March 2009 and November 2011, 6341 patients underwent coronary CTA at one institution. The prevalence of CAF was retrospectively eval...
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Although congenital coronary artery anomalies are seen in 0.6–1 % of adult patients undergoing coronary angiography, the data for the pediatric population are few. This study of 22 children with coronary artery anomalies evaluated them in terms of demographic and clinical features and analyzed their angiographic findings and surgical results. Databases in the Department of Pediatric Cardiology at the University of Uludag were searched for all the patients with a diagnosis of congenital coronary ...
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Coronary artery fistulae are uncommon, reported in 0.25% of patients undergoing coronary angiography. Two patients with congenital coronary artery fistula and coronary artery disease who presented with symptoms of exacerbated congestive heart failure out of proportion to their atherosclerotic burden were successfully treated by epicardial fistula ligation and coronary artery bypass grafting with marked improvement in functional status.
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Abstract Coronary artery fistula is an abnormal communication between the coronary artery and either the cardiac chamber or the great vessel. In particular, the coronary-to-pulmonary artery fistula can be supplied by either one or both coronary arteries and drains to the pulmonary trunk. We report a unique case of fistula originating from both coronary arteries and draining into both sinuses of the main pulmonary artery in a 57-year-old female who experienced chronic chest pain and palpitation. ...
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