Clinical characteristics of congenital coronary artery fistulas and its coronary angiographic results anal-ysis / 心血管康复医学杂志

ABSTRACT

Objective:To explore clinical and fistula origin characteristics of congenital coronary artery fistula (CAF).Methods:Clinical and coronary angiographic (CAG)data of 37 congenital CAF patients,who were treated in our hospital from Apr 2011 to Aug 2016 and diagnosed by CAG,were retrospectively analyzed.Chief complaint symptoms were analyzed.According to fistula origin location,patients were divided into left anterior descending (LAD)group (n=23),right coronary artery (RCA)group (n=6),LAD & RCA group (n=2),left circumflex (LCX)group (n=5)and left main (LM)group (n=1).Characteristics of fistula origin and drainage location dis-tribution were analyzed.Results:Among the chief complaints of 37 congenital CAF patients,there were 24 cases (64.9%)of chest tightness and short of breath,six cases (16.2%)of chest pain,five cases (13.5%)of palpitations and two cases (5.4%)of heart murmur in physical examination.Compared with RCA group,LAD & RCA group, LCX group and LM group,there was significant rise in percentage of LAD fistula origin (16.2%,5.4%,13.5%, 2.7% vs.62.2%),P <0.01 all,but there were no significant difference among other groups,P >0.05 all.The 23 cases of LAD fistula origin included 22 cases of pulmonary artery fistulas (PAF)and one case of bronchial artery fis-tulas (BAF);the six cases of RCA fistula origin included three cases of PAF,two cases of right atrial fistulas (RAF) and one case of left ventricular fistulas (LVF);the five cases of LCX fistula origin included two cases of RAF,and one case of PAF,LVF and RVF respectively.Conclusion:Coronary angiography is the gold standard to diagnose congenital CAF.Percentage of congenital CAF originated from left coronary artery is significantly more than that of right coronary artery.