Surgical Management of 56 Patients with Congenital Coronary Artery Fistulas

Urrutia-S., Carlos O.; Falaschi, Giorgio; Ott, David A.; Cooley, Denton A.

doi:10.1016/s0003-4975(10)61563-9

Cited by 203 publications

(157 citation statements)

References 21 publications

Supporting

Mentioning

148

Contrasting

Unclassified

Order By: Relevance

“…1,3,5,12) In this case, the patient had neither symptoms nor complications related to coronary arteriovenous fistulas until the rupture. It is difficult to recommend surgical treatment for all asymptomatic patients with a coronary arteriovenous fistula.…”

Section: Discussionmentioning

confidence: 69%

Rupture of a Giant Saccular Aneurysm of Coronary Arteriovenous Fistulas.

Ito

Kodama

Saeki³

et al. 2000

Jpn Heart J

View full text Add to dashboard Cite

SUMMARYA 58-year-old Japanese woman was admitted to our hospital because of chest pain. A continuous murmur was detected at the left parasternal area. Electrocardiogram showed ST elevation in leads V 2 , V 3 and V 4 . Chest computed tomography and echocardiography demonstrated pericardial effusion and a large mass which was adjacent to the pulmonary artery. An abnormal blood flow was detected in the mass by Doppler echocardiography. Coronary angiography confirmed that the mass was a giant aneurysm of coronary arteriovenous fistula arising from both the left and right coronary arteries. This patient had no symptoms until rupture of the fistula. Rupture of a coronary arteriovenous fistula is very rare but can be a cause of chest pain and pericardial effusion. 1) Therapeutic strategies for coronary arteriovenous fistulas have not been clearly defined because the natural histories of the disorder are still uncertain.2) The majority of coronary arteriovenous fistulas are small and asymptomatic, especially in young patients. In older patients, both symptoms and fistula-related complications increase.3) Surgical repair for coronary arteriovenous fistulas is generally recommended in the presence of symptoms of heart failure or large left-to-right shunts. 4)On the other hand, the management for asymptomatic patients with a coronary arteriovenous fistula is controversial. We report the rupture of a giant aneurysm of a coronary arteriovenous fistula presented by chest pain with pericardial effusion. The patient had no fistula-related symptoms until the rupture.

show abstract

Section: Discussionmentioning

confidence: 69%

Rupture of a Giant Saccular Aneurysm of Coronary Arteriovenous Fistulas.

Ito

Kodama

Saeki³

et al. 2000

Jpn Heart J

View full text Add to dashboard Cite

show abstract

“…They are frequently associated with other congenital cardiac defects like atrial septal defect, tetralogy ofFallot, patent ductus arteriosus, ventricular septal defect,and pulmonary atresia. [6][7][8][9] Edwards classification of primary and secondary fistulas define primary fistula as the main pathological lesion and secondary fistula occurs as a consequence of other cardiac malformations such as aortic or pulmonary atresia. The secondary fistula are rare and we describe all cases of primary CAF in our case series.…”

Section: Discussionmentioning

confidence: 99%

“…[9] Symptoms and sign of CAF are variable and may depend on size and site of drainage. It may be asymptomatic in many patients and may be detected incidentally.Some asymptmatic patients may come to clinical attention due to continous or systolic murmur along the upper left parasternal border in cases of CPAF.…”

Section: Discussionmentioning

confidence: 99%

Coronary pulmonary artery fistula: A case series with review of the literature

Shah¹,

Kamath

2016

Int J of Biomed & Adv Res

View full text Add to dashboard Cite

Objective: To describe the clinical, angiographic profile and management strategies of patients of coronary pulmonary arterial fistulas presenting to a tertiary care center in a developing country. Methods: All patients with coronary pulmonary artery fistula (CPAF) diagnosed using coronary angiogram in last two years i.e. 2011-2013 in a tertiary care center in South India were included in the study. Ten adult patients were treated for coronary pulmonary artery fistulas. Results: Mean age was 56± 7.7 years (range 45-80 years) with no gender preponderance. Chest pain was the predominant symptom in 60 % of patients followed by giddiness and syncope. Only 20 % patients were found to have continuous or systolic murmur on auscultation. Majority of the fistulas were found to be originating from the left anterior descending artery (LAD), most commonly from proximal segment (n = 5). Majority (n = 9) responded to conservative management while one patient required surgical intervention. Conclusion: Coronary pulmonary arterial fistulas are rare coronary anomaly which often goes unnoticed. CPAF was most frequently seen in middle age with male preponderance arising from proximal LAD. Patients present with diverse clinical presentations and subtle clinical findings. Majority of them being functionally insignificant, need only conservative measures.

show abstract

“…Congential coronary fistulae usually drain to the right side of the heart or the coronary sinus resulting in left -toright shunt; however, they may drain into the left atrium or left ventricle producing a picture of aortic regurgitation (from left-to-left shunt) and coronary steal. Although they may be asymptomatic and may remain so for many years or even diminish and close spontaneously (Francis et al, 1979;Lowe et al, 1981;Mahoney et al, 1982) they are frequently associated with symptoms and complications especially during middle and old age (Alter et al, 1977;Austin et al, 1977;Fallehnejad et al, 1980;Koller et al, 1980;Liberthson et al, 1979;Lowe et al, 1981;Lowe and Sabiston, 1982;Macri et al, 1982;Meyer et al, 1975;Pellegrini et al, 1980;Przybojewski, 1982;Rittenhouse et at., 1975;Snyder et al, 1978;Stanley et at., 1981;Starling et al, 1981;Thandroyen and Matisonn, 1981;Theman and Crosby, 1981;Urrutia-S et al, 1983;Vemeyre et al, 1979;Vogelbach et al, 1979;Wilde and Watt, 1980). Symptomatology may be produced by a compromise of coronary perfusion (angina, arrhythmias, dyspnea), or by the left-to-right shunt (dyspnea, atrial tachyarrhythmias, congestive heart failure, pulmonary hypertension).…”

Section: Case Reportmentioning

confidence: 99%

“…Although they may be small without clinical sequellae, in many instances they are associated with myocardial ischemia, angina, infectious endocarditis, thrombosis, aneurysmal dilatation and rupture, rhythm disturbances, dyspnea, left-to-right shunt with congestive heart failure or pulmonary hypertension, "signs of aortic leak and coronary steal, ' , embolization and acute myocardial infarction (Liberthson et al, 1979;Lowe et al, 1981;Lowe and Sabiston, 1982;Macri et al, 1982;Meyer et al, 1975;Rittenhouse et al, 1975;Stanley et al, 1981;Theman and Crosby, 1981;U rrutia-S et al, 1983;Vogelbach et al, 1979;Wilde and Watt, 1980). Since the incidence of these complications increases with age and surgical treatment carries a low mortality and is considered "curative," surgery is usually recommended in symptomatic and even in asymptomatic patients (Liberthson et al, 1979;Lowe et al , 1981;Lowe and Sabiston, 1982;Macri et al, 1982;Meyer et al, 1975;Rittenhouse et al, 1975;Urrutia-S et al, 1983;Wilde and Watt, 1980). The surgical approach is dictated by the exact anatomy, and varies from simple ligation without cardiopulmonary bypass to intracardiac repair with cardiopulmonary bypass and cardioplegic arrest with associated vein graft revascularization (Liberthson et al, 1979;Lowe et al, 1981;Lowe and Sabiston, 1982;Meyer et al, 1975;Stanley et al, 1981;Theman and Crosby, 1981;Wilde and Watt, 1980).…”

Section: Introductionmentioning

confidence: 99%