Early and late presentation of coronary artery fistula: a possible natural progression?

Coronary artery fistulas after paediatric heart transplantation

Coronary artery fistulas have been described in patients after heart transplantation more often than in the normal population. We reviewed our centre's database between 2008 and 2020. Thirty patients had coronary angiography and 13 showed non-cameral coronary artery fistulas in their first coronary angiography. Distribution, degree and evolution of the fistulas and characteristics of transplant procedure, patient and immunosuppressive treatments were analysed.

Spontaneous "Coronary Bypass" in a Paediatric Transplanted Heart

We report an asymptomatic 5-year-old boy with coronary artery fistulas to pulmonary parenchyma and to systemic thoracic arteries, like a "natural bypass", detected during a coronary angiography performed 11 months after his heart transplant. One year later, a new coronary angiography showed no fistula. Some changes to immunosuppressive therapy during this time could be related to this evolution.