Congenital coronary artery fistula in children:The interventional management and outcome / 介入放射学杂志

ABSTRACT

Objective To assess the safety and efficacy of transcatheter closure of congenital coronary artery fistulas(CAFs).Methods Retrospective analysis was performed on 19 patients mean age of(5.5?4.1) years treated from February 1995 to December 2005 with transcatheter closure of CAFs using transcatheter spring coil embolization,Amplatzer PDA occluder or Amplatzer plug.One case had a residul fistula postoperatively associated with patent duetus arteriosus(PDA).Results The abnormal parameters included mean fistula diameter(3.7?1.6)mm(2.5-8.2 mm),pulmonary mean pressure(28.0?5.0)mmHg(25.0-67.0 mmHg)and pulmonary to systemic shunt(Qp/Qs)1,6?0.8(1.0-2.3).The sites of the fistulas were originated in right coronary artery 11,left anterior descending coronary artery or left circumflex coronary artery 8. Abnormal communication sites of these fistulas were to right ventricle in 14 and right atrium in 5.Various occlusion devices used to close these fistulas included one Giantureo coil in 10,2-4 Gianturco coils in 3, Duct-Occlud in 3,Amplatzer duct occluder in 2 and Amplatzer plug in 1.The post-operative residul fistula with PDA was treated successfully with PDA occlusion.The immediate,one month and one year complete occlusion rates were 55.6%(10/18),88.9%(16/18),100%(18/18),respectively.The coil slipped into the left pulmonary artery in 1 case and correction was obtained by retrieving with forceps.Follow-up studies at 3 months to 4.3 years showed complete abolition of shunt in all patients with no evidence of recanalization leading to recurrences of shunt.Conclusion Transcatheter closure of CAFs is a safe and effective alternative to surgical repair.