Congenital coronary arteriovenous fistula in children: A report of 12 cases and review of the literature.

ABSTRACT

Twelve children, 6 boys and 6 girls, with congenital coronary arteriovenous fistulas were retrospectively studied. The diagnoses were made at ages ranging from 2 days to 9 years. Three (twenty five per cent) of the patients had congestive heart failure, while the others had no symptoms. Abnormal physical findings included bounding pulse 9 cases (75 per cent), continuous murmur 7 case (58 per cent), pansystolic murmur 3 cases (25 per cent), and to and from murmur 2 cases (17 per cent). Cardiomegaly and increased pulmonary vascularity were demonstrated in the chest X-ray in 66 per cent of the patients. Electrocardiograms showed left ventricular hypertrophy in 58 percent of the patients. Provisional diagnoses of small ventricular septal defect, patent ductus arteriosus or catheterization were necessary in making definite diagnoses in which average Qp Qs was 1.71. Three patients (25 per cent) had other associated lesions i.e. patent ductus arteriosus and/or atrial septal defect. Ten patients received surgical treatment with good results.