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Percutaneous Treatment of Congenital Coronary Arteriovenous Fistulas

Percutaneous Treatment of Congenital Coronary Arteriovenous Fistulas Background: Congenital coronary arteriovenous fistulas (CAVF), although rare, can present as significant hemodynamic lesions necessitating intervention. Methods and results: Six patients (two males) with congenital coronary arteriovenous fistulas (CAVF) underwent percutaneous transcatheter occlusion. The ages ranged from 4 years to 49 years (mean 20.1 years). The fistulas had their origins from the right coronary artery (two), the left anterior descending coronary artery (two), and the left circumflex coronary artery (two). One of the fistulas drained to the right ventricle, four drained to the right atrium, and the remaining one to the left ventricle (LV). The fistulas were closed using the arterial approach with Cook™ coils in two patients and with nitinol ductal occluders (NDOs) using the venous approach in four patients. One patient developed dissection of the wall of the fistula during attempted closure and had spontaneous occlusion of the fistula. Complete occlusion of the fistulas were achieved in all patients. Complications consisted of migration and embolization of the coils in one patient (later closed successfully with NDO) and myocardial infarction occurring two weeks following successful closure in another patient. At mean follow‐up of 39.6 +/− 22.9 months, all patients were asymptomatic and echo‐Doppler evaluation revealed no residual fistulae. Conclusions: CAVF are very well amenable to percutaneous closure with acceptable morbidity and high success rates. (J Interven Cardiol 2011;24:208–215) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Percutaneous Treatment of Congenital Coronary Arteriovenous Fistulas

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References (29)

Publisher
Wiley
Copyright
©2011, Wiley Periodicals, Inc.
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.2010.00621.x
pmid
21649734
Publisher site
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Abstract

Background: Congenital coronary arteriovenous fistulas (CAVF), although rare, can present as significant hemodynamic lesions necessitating intervention. Methods and results: Six patients (two males) with congenital coronary arteriovenous fistulas (CAVF) underwent percutaneous transcatheter occlusion. The ages ranged from 4 years to 49 years (mean 20.1 years). The fistulas had their origins from the right coronary artery (two), the left anterior descending coronary artery (two), and the left circumflex coronary artery (two). One of the fistulas drained to the right ventricle, four drained to the right atrium, and the remaining one to the left ventricle (LV). The fistulas were closed using the arterial approach with Cook™ coils in two patients and with nitinol ductal occluders (NDOs) using the venous approach in four patients. One patient developed dissection of the wall of the fistula during attempted closure and had spontaneous occlusion of the fistula. Complete occlusion of the fistulas were achieved in all patients. Complications consisted of migration and embolization of the coils in one patient (later closed successfully with NDO) and myocardial infarction occurring two weeks following successful closure in another patient. At mean follow‐up of 39.6 +/− 22.9 months, all patients were asymptomatic and echo‐Doppler evaluation revealed no residual fistulae. Conclusions: CAVF are very well amenable to percutaneous closure with acceptable morbidity and high success rates. (J Interven Cardiol 2011;24:208–215)

Journal

Journal of Interventional Cardiology – Wiley

Published: Jun 1, 2011

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