Late outcome of repair of congenital coronary artery fistulas—a word of caution

Abstract

Perioperative myocardial infarction is an important complication of ligation of coronary artery fistulas and can contribute to reduced late survival. The tricuspid valve should be evaluated carefully at repair because of the relatively high rate of residual regurgitation in survivors.

Coronary Artery Fistulae

“…11 This may reflect selection bias because fistulae referred for surgical closure are usually not amenable to transcatheter closure or are associated with comorbid cardiac conditions requiring surgery. Specific complications include those seen with transcatheter closure, such as native coronary thrombosis or incomplete closure.…”

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

“…This incidence of complication increases to 63% in the age group greater than 20 years [5]. Said and associates [22] reported an early mortality of 2% and late mortality of 24% for 46 patients after CAF surgery. The researchers caution that perioperative myocardial infarction is an important complication that may contribute to reduced late survival [22].…”

“…Said and associates [22] reported an early mortality of 2% and late mortality of 24% for 46 patients after CAF surgery. The researchers caution that perioperative myocardial infarction is an important complication that may contribute to reduced late survival [22]. In their study [22], the median age at surgery was 59 years (range, 1 to 84), which was higher when compared with the other reported studies [11][12][13][14].…”

Coronary Fistulas: A Case Series

“…12 An associated coronary aneurysm can be resected, and the distal coronary flow can be maintained with either an interposition graft or a concomitant coronary artery bypass graft. 16 Catheter closure is actually the procedure of choice; a number of devices have been used including occlusion coils, vascular plugs, umbrella devices, covered stents and Histoacryl resin. 17 The choice of device depends on the anatomic characteristics of the fistula.…”