Coronary artery fistula (CAF) is a rare congenital anomaly that can be complicated by endocarditis, myocardial infarction, or coronary aneurysms. This article reviews the clinical characteristics and surgical outcome of 10 patients with CAF in Rajae Heart Center. From 1990 to 2000, 10 patients (age, 6 months to 15 years; mean age, 8.5 years) were diagnosed with CAF by echocardiography and cardiac catheterization. Six were female and 4 were male. All patients with isolated CAF (9) were asymptomatic. One patient with associated anomaly (mitral valve prolapse with severe mitral regurgitation) had dyspnea on exertion and palpitation. Five fistulas originated from the right coronary artery—three from the left and two from the left circumflex. Drainage was to the right ventricle (7), right atrium (2), and pulmonary artery (1). The ratio of pulmonary to systemic flow ranged between 1 and 1.6. All patients had surgical ligation. In the symptomatic patient, in addition to ligation, mitral valve replacement was performed. There was no operative or late death. Follow-up evaluation (range, 1–6 years; mean, 4.2 years) showed no evidence of recurrent or residual CAF. Surgical management of CAF is a safe and effective treatment resulting in 100% survival and clousure rate.
Similar content being viewed by others
References
S Balanescu G Sangiorgi S Castelvecchio M Medda L Inglese (2001) ArticleTitleCoronary atery fistulas: clinical conequences and methods of closure. A literature review Ital Heart J 2 669–676 Occurrence Handle11666095 Occurrence Handle1:STN:280:DC%2BD3MrmsVOnug%3D%3D
MM Barbosa T Katina HG Oliveria FE Neuenschwander EC Oliveria (1999) ArticleTitleDoppler echocardiographic features of coronary artery fistula: report of 8 cases J Am Soc Echocardiogr 12 149–154 Occurrence Handle9950974 Occurrence Handle1:STN:280:DyaK1M7jslOrsQ%3D%3D
RF Hobbs HD Millit PV Raghavan DS Moodie WC Sheldon (1982) ArticleTitleCoronary artery fistulae: a ten-year review Cleveland Clin Q 49 191–197 Occurrence Handle1:STN:280:BiyC1c%2FnslQ%3D
JP Kovalchin RG Grifka TC McQuinn RH Pignatelli T Geva (1995) ArticleTitleRight coronary artery to right atrium fistula mimicking a right atrial mass Am Heart J 130 907–909 Occurrence Handle7572604 Occurrence Handle10.1016/0002-8703(95)90095-0 Occurrence Handle1:STN:280:BymD387itlY%3D
LA Latson TJ Forbes JP Cheatham (1992) ArticleTitleTrancatheter coil embolization of a fistula from the posterior descending coronary artery to the right ventricle in a two-year-old child Am Heart J 124 1624–1626 Occurrence Handle1462924 Occurrence Handle10.1016/0002-8703(92)90083-8 Occurrence Handle1:STN:280:ByyD1MfhtFE%3D
PR Liberthson K Sagar JP Berkoben RM Weintraub FH Levine (1979) ArticleTitleCongenital coronary arteriovenous fistula. Report of 13 patients, review of literature and delineation of management Circulation 59 849–854 Occurrence Handle428095 Occurrence Handle1:STN:280:CSaC2cjksVI%3D
A Ludomirsky MP O'Laughlin GJ Reul CE Mullins (1990) ArticleTitleCongenital aneurysm of the right coronary artery with fistulous connection to the right atrial atrium Am Heart J 119 672–675 Occurrence Handle2309610 Occurrence Handle1:STN:280:By%2BC2sjovV0%3D
AJJT Rein I Yatsiv A Simcha (1988) ArticleTitleAn unusual presentation of right coronary atery fistula Br Heart J 59 598–600 Occurrence Handle3382575 Occurrence Handle1:STN:280:BieB2M7psVI%3D
P Sapin E Frantz A Jain TC Nichols GJ Dehmer (1990) ArticleTitleCoronary artery fistula: an abnormality affecting all age groups Medicine 69 101–113 Occurrence Handle2319939 Occurrence Handle1:STN:280:By%2BB3crlvFA%3D Occurrence Handle10.1097/00005792-199069020-00004
MC Sherwood S Rockenmacher SD Colan T Geva (1999) ArticleTitlePrognostic significance of clinically silent coronary artery fistulas Am J Cardiol 83 407–411 Occurrence Handle10072233 Occurrence Handle10.1016/S0002-9149(98)00878-9 Occurrence Handle1:STN:280:DyaK1M7ntVCnuw%3D%3D
HC Stansel SuffixJr JE Fenn (1994) ArticleTitleCoronary arteriovenous fistula between the left coronary artery and persistent left superior vena cava complicated by bacterial endocarditis Ann Surg 160 292–296
TJ Starc FO Bowman AJ Hordof (1986) ArticleTitleCongestive heart failure in a newborn secondary to coronary artery–left ventricular fistula AM J Cardiol 58 366–367 Occurrence Handle3739933 Occurrence Handle10.1016/0002-9149(86)90083-4 Occurrence Handle1:STN:280:BimB1M3nsVM%3D
KR Sunder KG Balakrishnan JA Tharakan et al. (1997) ArticleTitleCoronary artery fistula in children and adults: a review of 25 cases with long-term observations Int J Cardiol 58 47–53 Occurrence Handle9021427 Occurrence Handle1:STN:280:ByiC2szlt1M%3D
V Thongtang P Panchavinnin S Chaithiraphan Y Sabasakul (1996) ArticleTitleCongenital coronary artery fistula: a report of 24 patients J Med Assoc Thai 79 630–634 Occurrence Handle8996997 Occurrence Handle1:STN:280:ByiC2M%2FktVM%3D
S Wang Q Wu S Hu et al. (2001) ArticleTitleSurgical treatment of 52 patients with congenital coronary artery fistulas Chin Med J (Engl) 114 752–755 Occurrence Handle1:STN:280:DC%2BD38%2FlsVOjsg%3D%3D
KT Wong S Menahem (2000) ArticleTitleCoronary arterial fistulas in childhood Cardiol Young 10 15–20 Occurrence Handle10695535 Occurrence Handle1:STN:280:DC%2BD3c7lvVSrsA%3D%3D Occurrence Handle10.1017/S1047951100006326
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Malekahmadi, M., Shahmohammadi, A. Surgical Outcome of Coronary Artery Fistulas Repair in Children. Pediatr Cardiol 26, 328–330 (2005). https://doi.org/10.1007/s00246-004-0656-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-004-0656-y