Surgical Treatment of Congenital Coronary Artery Fistulas: 27 Years' Experience and a Review of the Literature

Kamiya, Hiroyuki; Yasuda, Tamotsu; Nagamine, Hiroshi; Sakakibara, Naoki; Nishida, Satoru; Kawasuji, Michio; Watanabe, Go

doi:10.1111/j.1540-8191.2002.tb01195.x

Cited by 155 publications

(116 citation statements)

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“…10 Treatment of CAFs has included surgical ligation and percutaneous closure. 11 The results of surgical closure are generally satisfactory provided that the fistula has a single lumen. More recently, treatment with balloon-expandable polytetrafluoroethylenecovered coronary graft stents, and electrolytically detachable platinum coils has been described.…”

Section: Discussionmentioning

confidence: 99%

Imaging of Coronary Artery Fistulas by Multidetector Computed Tomography: Is Multidetector Computed Tomography Sensitive?

Kacmaz

Ozbulbul

Alyan

et al. 2008

Clinical Cardiology

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SummaryBackground: Coronary angiography is the gold standard for diagnosing coronary artery fistulas (CAFs). Multidetector computed tomography (MDCT) is a recently developed imaging technique for detecting coronary artery stenosis, coronary artery anomalies, and coronary artery fistulas and their courses.Objective: We aimed to determine accuracy or sensitivity of MDCT in patients having CAF.Method: We evaluated 13 patients with 15 CAFs detected earlier by coronary angiography. MDCT was carried out on all patients and the results were compared with coronary angiography, following which, sensitivity of MDCT was detected.Results: Eleven of 15 CAFs were shown on MDCT and the overall sensitivity of MDCT was found to be 73%. Seven of 8 CAFs that coursed between two vascular structures were detected and the sensitivity of MDCT

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Section: Discussionmentioning

confidence: 99%

Imaging of Coronary Artery Fistulas by Multidetector Computed Tomography: Is Multidetector Computed Tomography Sensitive?

Kacmaz

Ozbulbul

Alyan

et al. 2008

Clinical Cardiology

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“…Likewise, the most prevalent drainage site has been reported as the pulmonary artery (68%) with other destinations being the coronary sinus, right atrium, right ventricle, and very rarely the bronchial artery [1] . Our case is an unusual presentation of a patient with a coronary fistula originating from a proximal stenotic RCA and connecting to the left branch of the pulmonary artery and to an aberrant bronchial artery associated with left upper lung bronchiectasis, creating both left-to-right and left-to-left and shunts.…”

Section: Resultsmentioning

confidence: 99%

“…Similar procedures have been reported by ligation of the orifice of the feeder [6] . Kamiya et al report a 98% morbidity-free ten-year survival rate of those who underwent surgical correction, with a low-to-nil re-op rate, most likely due to initial low flow through the fistulae [1] . However, in our case, we had to account for both drainage sites being shut off after occluding the single feeder.…”

Section: Discussionmentioning

confidence: 99%

“…Since the feeder artery coursed in close proximity to the left pulmonary artery, the proximal fistula drainer at the pulmonary artery could have been formed by sheer proximity. Interestingly, the pulmonary artery has been reported as the most prevalent site of CAF drainage (68%) out of all drainer-vessels [1] . It can be hypothesized that separate entities created the separate drainers or that the pulmonary artery fistula arose first.…”

Section: Discussionmentioning

confidence: 99%

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Double Coronary Artery Fistulae: Clinical and Imaging Concerns, and a Review of the Literature

Maresky

Litovchik

Vered

et al. 2015

European Journal of Case Reports in Internal Medicine

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Coronary artery fistulae (CAF) are a rare entity describing abnormal communication between a coronary artery and cardiac chamber or a large intrathoracic vessel and are seldom described in the literature . These fistulae can be either congenital or acquired. Often incidental in finding, CAFs can have serious clinical sequelae, and should be duly reported and discussed with the cardiac team. More than 50% of patients with CAFs may be asymptomatic; 34% may report chest pain; 13% may have symptoms of heart failure, and a minority of 2% may suffer from endocarditis and arrhythmias . The largest series to our knowledge was reported by the Cleveland Clinic, which found 225 patients with incidental CAF out of 126,595 coronary catheterizations (incidence of 0.18%), performed during a span of 28 years . Multiple CAFs are an even rarer entity and only a handful of cases have been reported in the literature to date. Few cases of double CAFs have been reported that describe two different feeder coronary arteries giving rise to separate drainage sites . In our report, however, we describe a new entity: a single-feeder coronary vessel communicated with two drainage sites. Our case is curiously unique, in which we report a single artery, originating from the right coronary artery (RCA) with double drainage sites -one to the left pulmonary artery and the second to the left bronchial artery. LEARNING POINTS• Cardiac CTA confers added value in identification of both normal and abberant coronary vessels.• Maximal Intensity Projection (MIP) & 3D volumetric reconstructions are of added value in every cardiac CTA due to its all-encompassing view of the heart. These techniques have been incorporated and are routinely used in all our Cardiac CTAs.• Curved MIP reconstructions of the coronary arteries, combined with 3D volumetric reconstruction of the heart, allows comprehensive evaluation of the coronary arteries, especially in complicated cases.• Due to its anatomic and 3-dimensional properties -not only of the heart -but of the entire thorax, cardiac CTA is ideal for evaluation of fistulae between coronary arteries and adjacent vessels.• Cardiac CTA may facilitate the illustration of single-feeder, double-drainer coronary artery fistulae, which was not clearly identified in our case during conventional coronary angiography. KEYWORDS Coronary artery fistula, abberant coronary artery, cardiac CT, cardiac catheterization CASE PRESENTATIONA 65-year-old male with longstanding metabolic syndrome and ischemic heart disease presented to the ED with chest pain and dyspnea. Fifteen years earlier, the patient underwent coronary artery bypass, which included Left Internal Mammary Artery to Left Anterior Descending Artery (LIMA-to-LAD) and SVG-to-M1. Due to his clinical manifestation, a diagnostic angiography study was performed, and a stent was inserted into a tight stenosis of the proximal SVG. Incidentally, a tortuous vessel was revealed: it originated from the RCA, passed upward and drained into a large vessel, where a turbulent steal ...

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“…The treatment of asymptomatic lesions is controversial, with some authors recommending early surgical intervention while others recommend a more conservative ap- proach. A symptomatic CAF can be treated by percutaneous transcatheter occlusion or suture obliteration [7]. The choice of treatment method depends on the anatomy and morphologic features of the fistula.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Fistulas Between Coronary and Pulmonary Arteries: Case Reports

Karaagac¹

2016

Ann Clin Anal Med

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ÖzetKonjenital koroner arter fistülü bir koroner arter ile diğer vasküler yapılar arasın-da direkt bağlantının olduğu nadir, izole bir anomalidir. Biz biri perkütan koil embolizasyon uygulaması ile, diğeri cerrahi olarak tedavi edilmiş iki konjenital koroner arteriyovenöz fistüllü vakayı sunduk. Anahtar KelimelerKoil Embolizasyon; Anjina Pektoris; Koroner Arter Fistülü AbstractCongenital coronary artery fistula is a rare, isolated anomaly that is defined as a direct communication between a coronary artery and another vascular structure.We report on two cases of congenital coronary arteriovenous fistulas, one treated by coil embolization and the other with surgery.

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Surgical Treatment of Congenital Coronary Artery Fistulas: 27 Years' Experience and a Review of the Literature

Abstract: Definitive surgical correction is safe and effective, with good results. Therefore, it should be considered even in asymptomatic patients because of the risk of future complications.

Cited by 155 publications

References 9 publications

Imaging of Coronary Artery Fistulas by Multidetector Computed Tomography: Is Multidetector Computed Tomography Sensitive?

Imaging of Coronary Artery Fistulas by Multidetector Computed Tomography: Is Multidetector Computed Tomography Sensitive?

Double Coronary Artery Fistulae: Clinical and Imaging Concerns, and a Review of the Literature

Coronary Artery Fistulas Between Coronary and Pulmonary Arteries: Case Reports

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