Transcatheter closure of coronary artery fistulae using the Amplatzer duct occluder

Behera, Sarina K.; Danon, Saar; Levi, Daniel S.; Moore, John W.

doi:10.1002/ccd.20811

Cited by 56 publications

(38 citation statements)

References 25 publications

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“…Transcatheter CAF closure can be performed using various devices including detachable coils, 13 Amplatzer vascular plug, 12 Amplatzer duct occluder, 8 detachable balloons, 14 and covered stents, 15 while the vast majority of the fistulas were closed using microcoils. 10,16 -18 Microcoils have made an important contribution to the technique of transcatheter CAF closure.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Congenital Coronary Artery Fistulae: Immediate and Long‐Term Follow‐Up Results

Zhu¹,

Zhang²,

Han³

et al. 2009

Clinical Cardiology

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BackgroundTranscatheter closure of coronary artery fistulae (CAF) has emerged as an alternative to surgery, but there are no long‐term outcome results.ObjectiveWe report immediate and long‐term results in 24 patients after transcatheter closure of congen‐ ital CAF.MethodsA total of 24 patients aged 5 to 56 years old with congenital CAF underwent attempted percutaneous transcatheter closure using various devices between November 1998 and August 2008. The immediate closure results and clinical follow‐up were reviewed.ResultsOf the 24 patients, 20 (83.3%) underwent successful transcatheter closure using various devices. An angiogram right after device deployment revealed complete occlusion in 15 patients (75%) and trivial‐ to mild‐ residual flow in 5 patients (25%). Four patients (20%) had transient ST‐T wave changes after the procedure. The left ventricular end‐diastolic volume decreased from 165±31.4 mm3 to 128.6±24.4 mm3 (P = 0.012) 24 hours after procedure, and the cardiothoracic ratio from 0.57±0.02 to 0.53±0.01 (P = 0.003). Follow‐up was 100% complete and ranged from 3 months to 10 years. There were no early or late deaths. All patients were asymptomatic with complete closure of CAF except 1 patient (5%) who had a recurrence of shunt at 6‐month follow‐up, which was re‐closed by percutaneous technique.ConclusionTranscatheter closure of CAF is feasible and safe in anatomically suitable vessels and is a promising alternative to surgery in most patients. Copyright © 2009 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Congenital Coronary Artery Fistulae: Immediate and Long‐Term Follow‐Up Results

Zhu¹,

Zhang²,

Han³

et al. 2009

Clinical Cardiology

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“…18,19 Surgery has been the major therapy for severely symptomatic patients, 21,22 but is gradually being replaced by different PCI devices, including coils, stent graft or the Amplatzer duct occluder. 18,19,[22][23][24][25][26][27][28][29][30] However, surgery or interventional therapy should be used in patients with evident symptoms/signs, serious complications or large shunting (Qp/Qs >1.5).…”

Section: Discussionmentioning

confidence: 99%

Angiographic and Clinical Manifestations of Coronary Fistulas in Chinese People 15-Year Experience

Chiu

Shyu

Cheng

et al. 2008

Circ J

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“…Few LAD fistulas ended in the LV, RV, RA and LA [1,38,93,94] . The clinical presentations of LAD fistulas were usually chest pain [76] , angina pectoris [90,95] , dyspnea [41,82,92,[96][97][98] , fatigue [99] , palpitations [1,74] , syncope [100] , CHF [77,[101][102][103] or IE [1,38] . Cx fistulas terminated into the PA in (23%) [47,104] , but the majority ended in the CS in 40% [43,[105][106][107][108][109] and the RA in 15% [73,78,110] of cases.…”

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

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AIM:To describe the characteristics of coronary artery fistulas (CAFs) in adults, including donor vessels and whether termination was cameral or vascular. METHODS:A PubMed search was performed for articles between 2000 and 2010 to describe the current characteristics of congenital CAFs in adults. A group of 304 adults was collected. Clinical data, presentations, diagnostic modalities, angiographic fistula findings and treatment strategies were gathered and analyzed. With regard to CAF origin, the subjects were tabulated into unilateral, bilateral or multilateral fistulas and compared. The group was stratified into two major subsets according to the mode of termination; coronary-cameral fistulas (CCFs) and coronary-vascular fistulas (CVFs). A comparison was made between the two subsets. Fistula-related major complications [aneurysm formation, infective endocarditis (IE), myocardial infarction (MI), rupture, pericardial effusion (PE) and tamponade] were described. Coronary artery-ventricular multiple micro-fistulas and acquired CAFs were excluded as well as anomalous origin of the coronary arteries from the pulmonary artery (PA). RESULTS:A total of 304 adult subjects (47% male) with congenital CAFs were included. The mean age was 51.4 years (range, 18-86 years), with 20% older than 65 years of age. Dyspnea (31%), chest pain (23%) and angina pectoris (21%) were the prevalent clinical presentations. Continuous cardiac murmur was heard in 82% of the subjects. Of the applied diagnostic modalities, chest X-ray showed an abnormal shadow in 4% of the subjects. The cornerstone in establishing the diagnosis was echocardiography (68%), and conventional contrast coronary angiography (97%). However, multislice detector computed tomography was performed in 16%. The unilateral fistula originated from the left in 69% and from the right coronary artery in 31% of the subjects. Most patients (80%) had unilateral fistulas, 18% presented with bilateral fistulas and 2% with multilateral fistulas. Termination into the PA was reported in unilateral (44%), bilateral (73%) and multilateral (75%) fistulas. Fistulas with multiple origins (bilateral and multilateral) terminated more frequently into the PA (29%) than into other sites (10.6%) (P = 0.000). Aneurysmal formation was found in 14% of all subjects. Spontaneous rupture, PE and tamponade were reported in 2% of all subjects. In CCFs, the mean age was 46.2 years whereas in CVFs mean age was 55.6 years (P = 0.003). IE (4%) was exclusively associated with CCFs, while MI (2%) was only found in subjects with CVFs. Surgical ligation was frequently chosen for unilateral (57%), bilateral (51%) and multilateral fistulas (66%), but percutaneous therapeutic embolization (PTE) was increasingly reported (23%, 17% and 17%, respectively). CONCLUSION:Congenital CAFs are currently detected in elderly patients. Bilateral fistulas are more frequently reported and PTE is more frequently applied as a therapeutic strategy in adults.

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Transcatheter closure of coronary artery fistulae using the Amplatzer duct occluder

Abstract: Use of the ADO is applicable for transcatheter closure of significant CAF. Advantages of using the ADO include the antegrade approach, use of a single device, and effective CAF occlusion.

Cited by 56 publications

References 25 publications

Transcatheter Closure of Congenital Coronary Artery Fistulae: Immediate and Long‐Term Follow‐Up Results

Transcatheter Closure of Congenital Coronary Artery Fistulae: Immediate and Long‐Term Follow‐Up Results

Angiographic and Clinical Manifestations of Coronary Fistulas in Chinese People 15-Year Experience

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

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