Early Surgical Repair of the Coronary Artery Fistulae in Children: 30 Years of Experience

Yim, Deane; Yong, Matthew S.; d’Udekem, Yves; Konstantinov, Igor E.

doi:10.1016/j.athoracsur.2015.02.044

Cited by 26 publications

(35 citation statements)

References 24 publications

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“…In our study, the source of the fistula was most often from the RCA with the left main coronary artery and its branches being much less involved. The most common fistula pattern was from RCA to right ventricle or right atrium, consistent with prior studies . However, other studies have suggested that the majority of fistulas originate from the left main coronary artery or its branches and terminate in the right atrium, right ventricle or pulmonary trunk .…”

Section: Discussionsupporting

confidence: 87%

“…Not surprisingly, transcatheter closure had a shorter hospital length of stay and was associated with better postoperative left ventricular ejection fraction when compared to surgical closure. Transcatheter closure of CAF has become a feasible and effective alternative therapy to surgical closure with good outcome in previously published studies, with good long‐term results . Although we did not assess long‐term outcomes, our study supports the relative efficacy and short‐term safety of both transcatheter and surgical closure.…”

Section: Discussionsupporting

confidence: 69%

“…The most common fistula pattern was from RCA to right ventricle or right atrium, consistent with prior studies. [13][14][15] However, other studies have suggested that the majority of fistulas originate from the left main coronary artery or its branches and terminate in the right atrium, right ventricle or pulmonary trunk. 10,16 These differences may be related to a smaller sample size or differences between varying ethnic populations.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The clinical characteristics of coronary artery fistula anomalies in children and adults: A 24‐year experience

Huynh

Truong²,

Ngo

et al. 2019

Congenital Heart Disease

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Objectives The aim of our work is to investigate the clinical characteristics of coronary artery fistula (CAF) anomalies in South Vietnam. Methods This is a retrospective analysis of 119 patients with diagnosis of definite CAF between January 1992 and April 2016. The demographic, clinical, echocardiographic, and angiographic characteristics and management of CAF with short‐term outcomes are described. Results The median age was 15 years (range, 1‐79 years), with 49 male (41%) and 70 female (59%). There were 77 symptomatic patients (64.7%) and 91 patients (76.5%) who presented with a murmur. The electrocardiogram was abnormal in 45.4% and cardiac enlargement or increased pulmonary vasculature were seen in 76 patients (63.9%) on chest X‐ray. The sensitivity of echocardiography for CAF diagnosis was 79%. The source of the fistula was most often from the RCA (54%), most commonly to right atrium (34.5%) or right ventricle (31.1%). In comparison with surgery, transcatheter closure had a shorter hospital length of stay (5.4 ± 3.8 days vs 12.6 ± 6.5 days, P = .02) and better postprocedural left ventricular ejection fraction (67.9 ± 8.1% vs 62.9 ± 6.0%, P = .03). Conclusion The majority of fistula in this study originated from the RCA and terminated in the right atrium or the right ventricle. Transcatheter and surgical closure are both relatively safe and effective, with the potential for shortened length of hospital stay following transcatheter closure.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The clinical characteristics of coronary artery fistula anomalies in children and adults: A 24‐year experience

Huynh

Truong²,

Ngo

et al. 2019

Congenital Heart Disease

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“…In the literature, while the Cx was the least common source of a CF, the right heart chambers were the most common location of drainage 1-7. Although spontaneous closure has been demonstrated, either surgical or interventional closure of the CF was recommended during childhood, even though they were asymptomatic, because of the risks that can occur during adulthood, including myocardial ischaemia, endocarditis and the complications of long-standing left-to-right shunt 2,5,7…”

Section: Discussionmentioning

confidence: 99%

A circumflex coronary artery-to-right atrial fistula in a 10-month-old child

Şişli

Ayık

Akyüz

et al. 2016

CVJA

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A coronary fistula (CF) is a rare congenital cardiac anomaly in which there is a connection between the coronary artery and a cardiac chamber or a great vessel. In the paediatric population, a CF is usually asymptomatic. While the circumflex coronary artery (Cx) is the least common source of a CF, the right heart chambers are the most common location of drainage. Herein, we present a symptomatic 10-month-old boy with an atrial septal defect (ASD) in whom we incidentally detected a CF, which stemmed from the Cx and drained to the right atrium. Because the patient was symptomatic and his small size was not appropriate for percutaneous closure of the ASD, surgical closure of the ASD and CF was performed.

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“…Closure treatment (surgical or transcatheter) can be used to prevent many complications, including spontaneous rupture, myocardial ischemia, heart failure, and thromboembolic events. Although CAF occurs more frequently in the right coronary artery (50%‐60%) and the fistula most often enters the right heart (80%), usually the right ventricle (14%—40%), complication involving infective endocarditis is rare . Coronary artery fistulae complicated with infective endocarditis have been reported to account for about 4%‐10% of total cases .…”

Section: Case Presentationmentioning

confidence: 99%

Right coronary artery–right ventricular fistula complicated with infective endocarditis

et al. 2020

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Coronary artery fistula (CAF) is a congenital disease in which a communication forms between one or more coronary arteries and a cardiac chamber or great vessel. We describe an infrequent case of right coronary artery (RCA) fistula into the right ventricle (RV) complicated by infective endocarditis in a child. The patient received echocardiography and contrast‐enhanced multidetector computed tomography (MDCT). Surgical treatment was performed after management of the infection. Unfortunately, a residual fistula formed after surgery. However, interestingly, the residual fistula spontaneously resolved at one year after surgery. He is now in good condition and totally asymptomatic.

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Early Surgical Repair of the Coronary Artery Fistulae in Children: 30 Years of Experience

Cited by 26 publications

References 24 publications

The clinical characteristics of coronary artery fistula anomalies in children and adults: A 24‐year experience

The clinical characteristics of coronary artery fistula anomalies in children and adults: A 24‐year experience

A circumflex coronary artery-to-right atrial fistula in a 10-month-old child

Right coronary artery–right ventricular fistula complicated with infective endocarditis

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