Coronary cameral fistula treated by the Amplatzer vascular plug

Abstract

Coronary artery anomalies occur in less than 1 % of the general population. With the advent of multidetector rows and 3D reconstruction, multidetector computed tomography has emerged as the modality of choice in the delineation of the complex coronary anatomy and diagnosis of coronary artery anomalies, helping in the institution of appropriate therapy. We report a case of coronary cameral fistula of the left anterior descending artery to the right ventricle, which was closed by an Amplatzer vascular plug. Coronary CT angiography was used to evaluate the patient prior to the procedure to locate the placement site for the vascular plug.

Transcatheter Closure of Coronary Artery Fistulae: Considerations and Approaches Based on Fistula Origin

“…Transcatheter closure is a suitable and a valuable alternative to conventional surgical closure in most cases of CAF . Many TCC techniques, occlusion devices and approaches have been described to effectively treat CAF . However, variability in age, size, symptoms, and CAF anatomy pose substantial challenges for TCC.…”

“…As multiple coils are needed for closure of large CAF, there is higher risk of coil embolization, increase in fluoroscopy time, contrast load, and possibility of failure to occlude the fistula . Therefore, over the past decade there has been preferential use of various ductal occluders, vascular plugs, and VSD occluders for large CAF …”

“…12 Therefore, over the past decade there has been preferential use of various ductal occluders, vascular plugs, and VSD occluders for large CAF. 10,13,19,20 There were 3 primary transcatheter approaches used in our experience for closure of all CAF (Figures 1-4). We used AV loop approach 3,12,13 successfully in the majority of our patients (61%) with medium to large CAF as illustrated in Figures 1 and 2.…”

“…10,13,19,20 There were 3 primary transcatheter approaches used in our experience for closure of all CAF (Figures 1-4). We used AV loop approach 3,12,13 successfully in the majority of our patients (61%) with medium to large CAF as illustrated in Figures 1 and 2. The advantages of this approach include a smaller sheath in the arterial side, the ability to use desired large caliber delivery sheath or guide catheter from the venous end, and simultaneous retrograde angiography from the arterial side allowing precise positioning and delivery of the device.…”

Coronary-Cameral Fistula Connecting the Left Anterior Descending Artery and the First Obtuse Marginal Artery to the Left Ventricle: A Rare Finding

“…Coronary artery anomalies occur in less than one percent of the general population [ 1 ]. Coronary-cameral fistulas are the abnormal vascular connections between coronary arteries and cardiac chambers.…”