Iatrogenic Aortocoronary Arteriovenous Fistula: Percutaneous Management of Iatrogenic Surgical Complication

Fanari, Zaher; Copeland, Kevin; Hopkins, James

doi:10.1016/s0735-1097(15)60685-4

Cited by 1 publication

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“…Since re‐do surgery has increased risks, 30 the use of PCI has increased over time. In our literature review, 56.3% of reported cases underwent percutaneous management of ACAVF, including balloon 31,32 or coils 33,34 embolization, covered stents, and Amplatzer vascular plug 35 (AVP). Coil embolization was performed successfully in 13 cases with three failed attempts resulting in choosing another strategy.…”

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confidence: 99%

Inadvertent aortocoronary arteriovenous fistula after CABG: Systematic review of case reports

Chen

Scridon

Chait

2020

Cathet Cardio Intervent

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Objective: To summarize published case reports of aortocoronary arteriovenous fistula (ACAVF) after coronary artery bypass grafting surgery (CABG). Background: Inadvertent ACAVF is a rare complication following CABG. However, the incidence continues to rise, and its management details and clinical outcomes have not been well described. Methods: To identify all published cases of ACAVF following CABG, PubMed, EMBASE, and Scopus were searched through November 2019. We defined ACAVF as inadvertent attachment of the grafting vessel onto a cardiac vein instead of targeted coronary artery. A systematic review was performed to identify the incidence, clinical features, and management outcomes. Results: A total of 48 post-CABG ACAVF cases were gathered. Among these patients, the mean age was 61.9 years and 79.2% were men. Most common presenting symptoms were chest pain (60.4%) and dyspnea (27.1%). The average onset of symptoms was 3 years; however, 54.2% of patients developed symptoms within the first year. The majority of cases reported targeted native vessel LAD during CABG (62.5%). Of these cases, 9 (18.8%) were managed conservatively, 8 (16.7%) chose to undergo surgery including ligation of fistula and repeat CABG, and 27 (56.3%) underwent percutaneous closure. Among these patients 13 cases (27.1%) were managed with coil embolization, 5 (10.4%) with balloon embolization, 5 (10.4%) were treated with a covered stent, and 4 (8.3%) used a vascular plug. There were no reported complications following treatment in this group. Conclusions: Inadvertent ACAVF are rare following CABG. Percutaneous closure was feasible and safe in treating these patients.

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