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Moges T, Ahmed H, Gisila A. Large cameral coronary artery fistula in a 5 months old infant with unusual presentation and fatal outcome: -case report. BMC Pediatr 2023; 23:385. [PMID: 37543567 PMCID: PMC10403903 DOI: 10.1186/s12887-023-04196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/18/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Congenital coronary fistulas (CAFs) are uncommon abnormalities communicating the coronary arteries with the cardiac chambers or portion of the systemic or pulmonary circulation. Over 90% of the cases drain into the right side of the heart with only 3% terminating in the left ventricle. Infants with a large CAFs may develop congestive heart failure. CASE PRESENTATION A 5 months old female infant presented with labored breathing and worsening of bluish discoloration of the lips and extremities following a prolonged cry. She had a history of breastfeeding difficulty and noticeable bluish discoloration of the lips and extremities since birth. The infant was wasted and had a fast heart rate, bluish lips, and nail beds with clubbing of fingers and toes. A cardiac murmur was noted during her medical checkup. Chest x-ray showed cardiomegaly. Echocardiography and CT angiography showed large Cameral CAF involving the left main and left anterior descending artery draining into the left ventricle. The tricuspid valve was dysplastic, there was secundum ASD, and VSD with a right to left shunt. The patient developed episode of cyanotic spells after crying excessively following a CT angiographic procedure which culminated in respiratory arrest and her demise. She was managed as a case of hypoxic spells in the ICU before her death. CONCLUSION This report unveiled unfamiliar case of Cameral coronary artery fistula with left-to-left shunting, cyanosis, and dysplastic tricuspid valve.
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Affiliation(s)
- Tamirat Moges
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia.
| | - Hayat Ahmed
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Azmeraw Gisila
- Department of Radiology School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
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An Up-to-Date Narrative Review on Congenital Heart Disease Percutaneous Treatment in Children Using Contemporary Devices. Diagnostics (Basel) 2022; 12:diagnostics12051189. [PMID: 35626343 PMCID: PMC9139868 DOI: 10.3390/diagnostics12051189] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Congenital heart pathology has a significant burden regarding morbidity and mortality in the pediatric population. Several transcatheter interventions and devices have been designed as an alternative to surgical repair. Percutaneous interventions have been proven to yield good results in most cases but with less stress and trauma than that attributed to surgical treatment, especially in frail pediatric patients. We aimed to review the literature and to investigate the feasibility and efficacy of transcatheter interventions and implantable devices for congenital heart disease management in children. Methods: We performed a search in Scopus and MEDLINE databases using prespecified keywords to retrieve clinical studies published between 2000 and 2021. Results: This article provides an up-to-date review regarding the applicability of interventional techniques in simple inter-atrial or inter-ventricular defects, and in challenging congenital defects, such as hypoplastic left heart syndrome, tetralogy of Fallot, or coronary artery fistula. Furthermore, we reviewed recent indications for defibrillator and cardiac resynchronization therapy, and new and promising devices currently being tested. Conclusion: Transcatheter treatment represents a feasible and efficient alternative to surgical repair of congenital heart defects. Novel devices could extend the indications and possibilities of percutaneous interventions in pediatric patients with congenital heart diseases.
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3
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Postsurgical coronary artery fistula after tetralogy of fallot repair. CIRUGIA CARDIOVASCULAR 2021. [DOI: 10.1016/j.circv.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Siripornpitak S, Sriprachyakul A, Promphan W, Mokarapong P, Wanitkun S. Coronary artery changes in congenital coronary-cameral fistulas evaluated by computed tomographic angiography. Jpn J Radiol 2021; 39:1149-1158. [PMID: 34181176 DOI: 10.1007/s11604-021-01164-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/21/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The study sought to determine coronary artery diameter in congenital coronary-cameral fistula (cCCF), factors associated with coronary artery aneurysm, coronary artery changes after fistula closure, and computed tomographic (CT) findings after treatment. MATERIALS AND METHODS We retrospectively reviewed CT findings of the cCCF for origins, terminations, fistula length, complexities, and Sakakibara classification. Coronary artery diameter was expressed as coronary artery Z score. Fistula features associated with coronary artery aneurysm were analyzed. Post-fistula closures were analyzed for coronary artery dilatation, coronary thrombosis, complete fistula closure, and fistula thrombosis. RESULTS Twenty-five patients (median age 33 months, interquartile range, IQR 25-48) were included. Coronary feeders and terminations were frequently right coronary artery (48%) and right ventricle (56%), respectively. Fistula aneurysm occurred in 52% of cases. Mean coronary artery Z score was 13.03 ± 6.36 with a high incidence of giant coronary artery aneurysm (68%). We found no statistically significant risk factors associated with coronary artery aneurysm (p value range 0.075-0.370). Median duration of the follow-up CT after closure of the fistulas was 6.4 months (IQR 5.0-8.7). Coronary artery Z score significantly decreased by 0.82 (IQR 0.28-1.35), p = 0.006 and coronary thrombosis occurred in 23% of cases during follow-up. CONCLUSIONS Large coronary aneurysm is common in cCCF. No characteristic feature of the fistula influencing coronary artery aneurysm is identified. There is a diminution in coronary artery Z score after fistula closure. Coronary thrombosis is a major complication after treatment.
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Affiliation(s)
- Suvipaporn Siripornpitak
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand. .,Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand.
| | - Apichaya Sriprachyakul
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand.,Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand
| | - Worakan Promphan
- Department of Pediatrics, Queen Sirikit National Institute of Child Health, Rangsit University, 420/8 Phayatai Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Pirapat Mokarapong
- Cardiovascular and Thoracic Surgery Unit, Department of Surgery, Institute of Cardiovascular Diseases, Rajavithi Hospital, 2 Phayatai Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Suthep Wanitkun
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand.,Division of Cardiology, Department of Pediatrics, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand
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5
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Amoozgar H, Edraki MR, Naghshzan A, Mehdizadegan N, Mohammadi H, Ajami G, Amirghofran AA. Midterm follow up of transcatheter closure of coronary artery fistula with Nit-Occlud® patent ductus arteriosus coil. BMC Cardiovasc Disord 2021; 21:192. [PMID: 33879042 PMCID: PMC8056487 DOI: 10.1186/s12872-021-01999-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary artery fistula (CAF) is a rare congenital anomaly with a challenging scenario in children. This study reports our experience in transcatheter closure of CAF with Nit-Occlude PDA coil and midterm clinical and imaging follow-up. METHODS Twelve children with congenital CAF between 2009 and 2019, mean age 2.05 ± 2.05 years (4 days to 7.2 years), mean weight 8.8 ± 4.83 (2.8-17 kg), who underwent transcatheter closure with PFM coil at the Namazi hospital, Shiraz, Iran, were reported. Echocardiography and electrocardiogram were done before and after the procedure (early, 3, and 6 months after), and Multi-slice computerized tomography or conventional coronary angiography was performed at least one year after closure. RESULTS In a median follow-up of 5.5 years (range 13 months to 8 years), retrogradely closed fistula had no residual, and the fistula tract was wholly occluded, but in most anterogradely closed fistula, had a small residual, which made the fistula tract open and need additional coil closure. CONCLUSIONS Transcatheter closure of CAF with PFM coil is feasible and effective with low mortality and morbidity, although antegrade closure with this device may be accompanied by residual shunt and need for multiple coil insertion.
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Affiliation(s)
- Hamid Amoozgar
- The Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Edraki
- The Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Naghshzan
- The Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. .,Cardiovascular and Neonatology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nima Mehdizadegan
- The Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Mohammadi
- The Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamhossein Ajami
- The Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Shah L, Kundapur D, Nosib S. Stolen from the coronaries: Left-to-Left shunts presenting as chest pain syndrome! BMJ Case Rep 2021; 14:e242425. [PMID: 33762294 PMCID: PMC7993208 DOI: 10.1136/bcr-2021-242425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/03/2022] Open
Abstract
We present the case of a 61-year-old woman with chest pain syndrome. Cardiac catheterisation did not reveal atherosclerotic coronary disease. However, a haemodynamically significant fistula connecting the left coronary artery to the left atrial appendage was found to be the culprit through a left-to-left shunting mechanism. In this report, we review the pathophysiology of coronary artery fistulas and the mechanism by which these fistulas may lead to 'coronary steal syndrome'. Indications for interventional and surgical management are outlined. Ultimately, we suggest the consideration of coronary artery fistulas in the differential diagnosis of patients presenting with chest pain.
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Affiliation(s)
- Love Shah
- Internal Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Deeksha Kundapur
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shravan Nosib
- Cardiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Wang X, Pang C, Liu X, Wang S, Zhang Z, Chen J, Zhuang J, Zhou C. Congenital coronary artery fistula in pediatric patients: transcatheter versus surgical closure. BMC Cardiovasc Disord 2020; 20:484. [PMID: 33198628 PMCID: PMC7670810 DOI: 10.1186/s12872-020-01769-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/05/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Transcatheter closure (TCC) and surgical closure (SC) are the two main approaches for congenital coronary artery fistula (CCAF), but data on the comparisons of the efficacy and safety of these two approaches are limited. METHODS We retrospectively reviewed pediatric patients with CCAF in Guangdong Cardiovascular Institute between January 2002 and December 2017. Patients who were qualified into our criteria were included into final analysis. The rate of successful closure and complications during hospitalization and at follow-up were compared between SC and TCC groups. RESULTS In total, 121 pediatric patients (male, n = 69; female, n = 52) with CCAF were divided to TCC (n = 63) and SC groups (n = 58) according to the indications. The mean age was 5.3 ± 1.4 years. The baseline characteristics of these two groups were similar except for the fistula anatomic feature. After adjusted for the fistula anatomy, compared to SC, TCC was associated with higher risk of major complications (p = 0.013). Proportions of patients requiring blood transfusion and intra-operative blood loss were higher in SC versus TCC groups, as were longer duration of hospital and ICU stay during hospitalization. In contrast, myocardial ischemia (10.2% vs 0.0%, p = 0.028), residual shunts (16.9% vs 3.6%, p = 0.045) and new-onset moderate-to-severe valve regurgitation (11.9% vs 0.0%, p = 0.013) were higher in TCC group versus SC groups during follow-up. CONCLUSIONS TCC has less invasive and faster recovery. However, SC had a higher successful rate and lower risk of major complications in pediatric patients.
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Affiliation(s)
- Xiaoyong Wang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510000, China
| | - Chengcheng Pang
- Department of Pediatric Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medicine, Guangzhou, China
| | - Xiaobing Liu
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510000, China
| | - Shushui Wang
- Department of Pediatric Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medicine, Guangzhou, China
| | - Zhiwei Zhang
- Department of Pediatric Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Academy of Medicine, Guangzhou, China
| | - Jimei Chen
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510000, China
| | - Jian Zhuang
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510000, China
| | - Chengbin Zhou
- Department of Cardiovascular Surgery, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510000, China.
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Incidentally detected small fistula flows in pulmonary artery by colour Doppler: echocardiographic findings and follow-up results. Cardiol Young 2019; 29:1435-1439. [PMID: 31662133 DOI: 10.1017/s1047951119002051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abnormal small fistulous flows in the pulmonary artery were detected on routine transthoracic echocardiography in asymptomatic patients by colour Doppler echocardiography. The most likely diagnosis is small coronary artery-pulmonary artery fistulas. We evaluated the clinical, echocardiographic, and follow-up findings of 101 patients. The mean age at first echocardiographic evaluation was 4.3 ± 4.2 years. In 79 (78.2%) of the patients, fistula flow in the pulmonary artery was diagnosed at the first presentation and the remaining 22 patients (21.8%) were diagnosed between the 2nd and 10th examination. The echocardiography indication was cardiac murmur in 42 (41.6%), routine cardiac control in 30 (29.7%), additional CHD in 14 (13.8%), non-specific chest pain in 11 (10.9%), suspicion of inflammatory heart disease in 2 (2%), and syncope in 2 (2%) patients. In 70 (69.3%) patients, fistulous flow was located in the anterior aspect of the main pulmonary artery, in 23 (22.8%) patients on the aortic side of the pulmonary artery and in 8 (7.9%) patients on the right pulmonary artery. Additional cardiac anomalies were ventricular septal defect in 8, patent ductus arteriosus in 6, atrial septal defect in 5, mitral valve prolapse in 4, coarctation of aorta in 4, bicuspid aortic valve in 3, and Kawasaki syndrome in 1 patient. Sixty-four patients (63.3%) were followed during a mean of 52.6 ± 43.7 months. Spontaneous closure was detected in only three patients; the others remained almost unchanged during the follow-up. Since the fistulas are thin and hemodynamically insignificant, echocardiography is an appropriate method to monitor these patients without performing any invasive diagnostic procedures for the fistula source.
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Abstract
We present two patients, one 10 years old and another 43 years old, who both had successful transcatheter closure of left main coronary artery to right atrium fistulas. The older patient had a larger fistula as well as more symptoms and a complicated post-procedure course. Closure of medium or large coronary artery fistulas should be considered at younger ages to minimise future complications.
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10
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Inoue T, Miyake T, Mushiake S. A case of coronary-pulmonary artery fistula with coronary artery aneurysm detected for Kawasaki disease remote phase. JOURNAL OF CLINICAL ULTRASOUND : JCU 2019; 47:508-510. [PMID: 31032930 DOI: 10.1002/jcu.22728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/10/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
Follow-up echocardiography showed two coronary-pulmonary artery fistulae and a coronary artery aneurysm in a 12-year-old boy who had been diagnosed with Kawasaki disease without persistent coronary artery lesion at the acute phase when he was 6-months-old. Left coronary arteriogram confirmed the fistulae and the 4.3 × 6.3 mm aneurysm. Results show that the fistula is associated with Kawasaki disease.
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Affiliation(s)
- Tomohiro Inoue
- Department of Pediatrics, Kindai University Nara Hospital, Ikoma, Japan
| | - Toshiharu Miyake
- Department of Pediatrics, Kindai University Nara Hospital, Ikoma, Japan
| | - Sotaro Mushiake
- Department of Pediatrics, Kindai University Nara Hospital, Ikoma, Japan
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Lo MH, Lin YJ. Response to coronary artery fistula presented as a mediastinum mass. J Formos Med Assoc 2019; 118:1270-1271. [PMID: 31076318 DOI: 10.1016/j.jfma.2019.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/23/2019] [Indexed: 06/09/2023] Open
Affiliation(s)
- Mao-Hung Lo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ying-Jui Lin
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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12
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Huynh KT, Truong VT, Ngo TNM, Dang TB, Mazur W, Chung ES, Tretter JT, Kereiakes DJ, Le TK, Pham VN. The clinical characteristics of coronary artery fistula anomalies in children and adults: A 24‐year experience. CONGENIT HEART DIS 2019; 14:772-777. [DOI: 10.1111/chd.12781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 04/02/2019] [Accepted: 04/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Kieu T. Huynh
- Department of Cardiology Tam Duc Heart Hospital Ho Chi Minh City Vietnam
| | - Vien T. Truong
- Department of Cardiology The Sue and Bill Butler Research Fellow, The Linder Research Center Cincinnati Ohio USA
- Department of Cardiology The Christ Hospital Health Network and The Lindner Research Center Cincinnati, Ohio USA
| | - Tam N. M. Ngo
- Department of Cardiology The Christ Hospital Health Network and The Lindner Research Center Cincinnati, Ohio USA
- Department of Cardiology Pham Ngoc Thach University of Medicine Ho Chi Minh City Vietnam
| | - Thao B. Dang
- Department of Cardiology Tan Tao University School of Medicine Tan Duc Ecity, Long An Vietnam
| | - Wojciech Mazur
- Department of Cardiology The Christ Hospital Health Network and The Lindner Research Center Cincinnati, Ohio USA
| | - Eugene S. Chung
- Department of Cardiology The Christ Hospital Health Network and The Lindner Research Center Cincinnati, Ohio USA
- Department of Cardiology The Margo and Frank Homan Family Foundation Endowed Chair in Heart Failure
| | - Justin T. Tretter
- Department of Cardiology Heart Institute, Cincinnati Children’s Hospital Medical Center Cincinnati Ohio USA
| | - Dean J. Kereiakes
- Department of Cardiology The Christ Hospital Health Network and The Lindner Research Center Cincinnati, Ohio USA
| | - Tuyen K. Le
- Department of Cardiology Heart Institute of Ho Chi Minh City Ho Chi Minh City Vietnam
| | - Vinh N. Pham
- Department of Cardiology Tam Duc Heart Hospital Ho Chi Minh City Vietnam
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Lee SY, Hung ST, Wang KT, Ku HC. Coronary artery fistula presented as a mediastinal mass. J Formos Med Assoc 2019; 118:1268-1269. [PMID: 31036499 DOI: 10.1016/j.jfma.2019.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 04/15/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Shih-Yi Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taitung MacKay Memorial Hospital, MacKay Memorial Hospital, Taiwan; Mackay Medicine, Nursing & Management College, Taiwan
| | - Sho-Ting Hung
- Department of Radiology, Taitung MacKay Memorial Hospital, Taiwan
| | - Kuang-Te Wang
- Division of Cardiology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taiwan; Faculty of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Hui-Chun Ku
- Department of Life Science, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205, Taiwan.
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Guccione P, Di Molfetta A, Montefoschi D, Formigari R, Gagliardi MG. Percutaneous treatment of aneurysmatic right coronary fistula in an infant, pediatric cardiology. J Cardiovasc Med (Hagerstown) 2018; 19:505-508. [PMID: 30015779 DOI: 10.2459/jcm.0000000000000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Paolo Guccione
- Department of Pediatric Cardiology and Cardiac Surgery, Pediatric Hospital Bambino, Gesù, Rome, Italy
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Buccheri D, Chirco PR, Geraci S, Caramanno G, Cortese B. Coronary Artery Fistulae: Anatomy, Diagnosis and Management Strategies. Heart Lung Circ 2018; 27:940-951. [PMID: 29503240 DOI: 10.1016/j.hlc.2017.07.014] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 04/03/2017] [Accepted: 07/10/2017] [Indexed: 12/27/2022]
Abstract
Coronary artery fistula (CAF) is a relatively rare anatomic abnormality of the coronary arteries that afflicts 0.002% of the general population and represents 14% of all the anomalies of coronary arteries. Its clinical relevance focusses mainly on the mechanism of "coronary steal phenomenon", causing myocardial functional ischaemia even in the absence of stenosis, hence common symptoms are angina or effort dyspnoea. The suggested diagnostic approach is guided by the patient's symptoms and consists of a number of instrumental examinations like ECG, treadmill test, echocardiography, computed tomography scan, cardiac magnetic resonance and coronary angiography. If it is not an incidental finding, coronary angiography is required in view of the optimal therapeutic planning. Small-sized fistulae are usually asymptomatic and have an excellent prognosis if managed medically with clinical follow-up with echocardiography every 2 to 5 years. In the case of symptomatic, large-sized or giant fistulae an invasive treatment, by transcatheter approach or surgical ligation, is usually a reasonable choice, and both strategies show equivalent results at long-term follow-up. Antibiotic prophylaxis for the prevention of bacterial endocarditis is recommended in all patients with coronary artery fistulae who undergo dental, gastrointestinal or urological procedures. A life-long follow-up is always essential to ensure that the patient is not undergoing progression of disease or further cardiac complications.
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Affiliation(s)
- Dario Buccheri
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy.
| | - Paola Rosa Chirco
- Emergency Department, Paolo Giaccone University Hospital, Palermo, Italy
| | - Salvatore Geraci
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Giuseppe Caramanno
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
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