ABSTRACT
BACKGROUND AND PURPOSE: Congenital coronary artery fistula (CAF) is an uncommon anomaly. It can become symptomatic, associated with significant morbidity and mortality. We report our experience in percutaneous treatment of CAF. METHODS AND RESULTS: Four patients with five CAFs were treated. All were symptomatic at admission. Four fistulas rose from the left anterior descending coronary artery. The fifth originated from the right coronary sinus. All drained into the pulmonary artery. Percutaneous treatment was performed using microcoils in two cases and Hydrocoils in the last two patients (three fistulas). A complete occlusion was achieved in all. There was no complication related with the procedure, and all were asymptomatic at the follow-up. CONCLUSIONS: Transcatheter closure of CAFs with microcoils/Hydrocoils is feasible and safe in the anatomically suitable vessels, with low rates of complications. Percutaneous treatment with microcoils/Hydrocoils is a valid option in symptomatic patients.
Subject(s)
Arterio-Arterial Fistula/therapy , Arteriovenous Fistula/therapy , Coronary Sinus/abnormalities , Coronary Vessel Anomalies/therapy , Embolization, Therapeutic , Pulmonary Artery/abnormalities , Arterio-Arterial Fistula/diagnostic imaging , Arteriovenous Fistula/diagnostic imaging , Coronary Angiography , Coronary Sinus/diagnostic imaging , Coronary Vessel Anomalies/diagnostic imaging , Embolization, Therapeutic/instrumentation , Equipment Design , Humans , Male , Pulmonary Artery/diagnostic imaging , Treatment OutcomeABSTRACT
BACKGROUND: Patients of > or =70 years of age and with acute coronary syndrome accumulate more risk factors with poor outcomes. Surgical revascularization is associated with increased mortality when compared with young population. The aim of this study was to communicate a single, small center experience, of percutaneous coronary intervention in the elderly in poststent era. PATIENTS AND METHODS: Seventy-five consecutive patients, > or =70 years of age, with myocardial infarction (MI) at admission, between January, 2005 and November, 2006. We evaluate major and minor events during hospitalization. RESULTS: Patients (64%) were male, 53.3% hypertension, 38.7% diabetes mellitus. Clinical presentation was: ST-segment elevation MI 53.3% and 5.3% with cardiogenic shock. Mean left ventricle ejection fraction was 48.5 +/- 18%. The procedure was successful in all the cases and culprit lesions received at least one stent in 93.4%. In-hospital major events were registered in 6.6% of cases: 3 (4%) death and 2 (2.6%) nonfatal MI; minor complications were registered in 5.2% of cases. CONCLUSION: Percutaneous coronary intervention in patients >70 years of age during MI is feasible and safe, with low rates of complications.
