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

Abstract

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.

Coronary artery–left ventricular multiple microfistulas, a rare disease that is easily missed: case report and literature review

“…Studies have shown that more than 70% of patients with CAFs have an obvious cardiac murmur in the prethoracic area. 1,2,15 However, patients with CALVMMFs often do not have an obvious cardiac murmur because the blood flow is diffused along the microvessels to the left ventricle, and turbulence does not readily develop in the cardiac cavity.…”

“…Most coronary artery fistulas (CAFs) are congenital, accounting for 0.2% to 0.4% of congenital heart diseases. 1 It is generally believed that the development of CAFs is related to incomplete degeneration of the sinusoids. 2 Most CAFs are simple fistulas that drain to low-pressure structures such as the right ventricle and pulmonary artery.…”

Surgical Repair for Left Coronary Artery-right Atrium Fistula With Giant Coronary Aneurysm: Case Report

“…The estimated prevalence of CAF is about 0.002% in general population and account for 0.2-0.4% of congenital heart disease and represent 14% of all the abnormalities of coronary [1.2]. Ectasia of the coronary artery which supply the stula with blood is a chronic effect which will lead to formation of coronary artery aneurysm [3]. CAF with coronary aneurysm is more prone to cause severe complications such as myocardial ischemia and aneurysm rupture so that it necessitates surgery treatment.…”

Surgical treatment of heart failure due to giant coronary artery fistula: a case report

“…Coronary artery fistula (CAF) is a rare anomaly of the coronary system that is characterized by a connection between one or more coronary arteries and a cardiac chamber or a great vessel of the systemic or pulmonary circulation. 1 CAF occurs in 0.002% of the general population and accounts for 0.2-0.4% of all congenital heart disease cases. The diagnosis of CAF is often made incidentally during coronary angiography, with a prevalence of 0.05-0.9%.…”