Surgical treatment of isolated fistulae of coronary arteries

Porto, J; Dias, José Pedro Esteves; Crevelari, Elizabeth Sartori

doi:10.1590/s0102-76382003000100014

Cited by 1 publication

(1 citation statement)

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“…There still remains a dispute for the surgical treatment of asymptomatic patients. Our study showed that surgical treatment of CAVFs when coexisting with other cardiac diseases is a safe procedure with low mortality and morbidity in accordance with the literature [3,7,8,10,14,19] . Thus, operating asymptomatic adult patients with low mortality and morbidity may reduce or eliminate the risk of subsequent development of complications such as myocardial infarction.…”

Section: Discussionsupporting

confidence: 90%

Coronary Arteriovenous Fistulas in Adult Patients: Surgical Management and Outcomes

Albeyoğlu¹,

Aldağ²,

Ciloglu³

et al. 2017

Braz J Cardiovasc Surg

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ObjectiveThe aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes.MethodsTwenty-one adult patients (12 female, 9 male; mean age: 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients. Demographic and clinical data were also collected. Postoperative courses of all patients were monitored and postoperative complications were noted.ResultsA total of 25 coronary arteriovenous fistulas were detected in 21 patients; the fistulas originated mainly from left anterior descending artery (n=9, 42.8%). Four (19.4%) patients had bilateral fistulas originating from both left anterior descending and right coronary artery. The main drainage site of coronary arteriovenous fistulas was the pulmonary artery (n=18, 85.7%). Twelve (57.1%) patients had isolated coronary arteriovenous fistulas and 4 (19.4%), concomitant coronary artery disease. Twenty (95.3%) of all patients were symptomatic. Seventeen patients were operated on with and 4 without cardiopulmonary bypass. There was no mortality. Three patients had postoperative atrial fibrillation. One patient had pericardial effusion causing cardiac tamponade who underwent reoperation.ConclusionThe decision of surgical management should be made on the size and the anatomical location of coronary arteriovenous fistulas and concomitant cardiac comorbidities. Surgical closure with ligation of coronary arteriovenous fistulas can be performed easily with on-pump or off-pump coronary artery bypass grafting, even in asymptomatic patients to prevent fistula related complications with very low risk of mortality and morbidity.

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