Coronary arteriovenous fistulas in adult patients: surgical management and outcomes
Rev. bras. cir. cardiovasc
; 32(1): 15-21, Jan.-Feb. 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-843463
Responsible library:
BR1.1
ABSTRACT
Abstract Objective:
The aim of this study was to describe the demographic, clinical and anatomic characteristics of coronary arteriovenous fistulas in adult patients who underwent open cardiac surgery and to review surgical management and outcomes.Methods:
Twenty-one adult patients (12 female, 9 male; mean age 56.1±7.9 years) who underwent surgical treatment for coronary arteriovenous fistulas were retrospectively included in this study. Coronary angiography, chest X-ray, electrocardiography and transthoracic echocardiography were preoperatively performed in all patients. Demographic and clinical data were also collected. Postoperative courses of all patients were monitored and postoperative complications were noted.Results:
A total of 25 coronary arteriovenous fistulas were detected in 21 patients; the fistulas originated mainly from left anterior descending artery (n=9, 42.8%). Four (19.4%) patients had bilateral fistulas originating from both left anterior descending and right coronary artery. The main drainage site of coronary arteriovenous fistulas was the pulmonary artery (n=18, 85.7%). Twelve (57.1%) patients had isolated coronary arteriovenous fistulas and 4 (19.4%), concomitant coronary artery disease. Twenty (95.3%) of all patients were symptomatic. Seventeen patients were operated on with and 4 without cardiopulmonary bypass. There was no mortality. Three patients had postoperative atrial fibrillation. One patient had pericardial effusion causing cardiac tamponade who underwent reoperation.Conclusion:
The decision of surgical management should be made on the size and the anatomical location of coronary arteriovenous fistulas and concomitant cardiac comorbidities. Surgical closure with ligation of coronary arteriovenous fistulas can be performed easily with on-pump or off-pump coronary artery bypass grafting, even in asymptomatic patients to prevent fistula related complications with very low risk of mortality and morbidity.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Coronary Artery Disease
/
Arteriovenous Fistula
/
Arterio-Arterial Fistula
/
Coronary Vessel Anomalies
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. bras. cir. cardiovasc
Journal subject:
Cardiology
/
CIRURGIA GERAL
Year:
2017
Document type:
Article
Affiliation country:
Turkey
Institution/Affiliation country:
Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital/TR