Coronary artery fistulae (CAF) are rare congenital anomalies. Surgical ligation is the standard treatment for symptomatic CAF, but is associated with higher morbidity. In a select group of patients, transcatheter coil embolization (TCE) is a reasonable alternative to standard surgical treatment. In this article, we present a unique (not previously reported) case of a tortuous accessory anomalous right coronary artery to pulmonary artery fistula with coronary steal phenomenon. TCE of highly tortuous fistulae can be technically difficult and are usually referred for surgery. In this case report we describe how utilization of adult coronary interventional wires and balloon catheters may help overcome some of the technical difficulties encountered with catheter-based closure of CAF.

A survey of adolescents living in rural southwestern towns demonstrated their knowledge of the basic transmission routes of Acquired Immune Deficiency Syndrome (AIDS). Nevertheless, misconceptions and attitudes, which may interfere with adopting safe behaviors, persist. Significant differences in knowledge did exist between the ethnic groups surveyed. Further, American Indian and black adolescents were more likely to express attitudinal biases against people who have AIDS. We conclude that current media efforts have been successful in communicating basic information regarding transmission, but there may exist a need for ethnically specific programs that focus on the misconceptions and attitudes surrounding AIDS.

No abstract