Abstract Objective To evaluate the short- and medium-term efficacy, complications, and anti-coagulation therapies related to transcatheter closure (TCC) of coronary artery fistula (CAF) in children. Methods We conducted a retrospective review of the medical records of 12 children with CAF who underwent TCC between January 2006 and January 2014, focusing on details such as preoperative, radiographic, and postoperative follow-up data, to record closure methods for CAF, anti-coagulation therapies, postoperative complications, and results of auxiliary examinations. Results Among the 12 cases who underwent successful TCC and whose age was 1-158 months, four patients had proximal/medium-sized CAF, five had proximal/large CAF, and three had distal/medium-sized CAF. The mean period of postoperative follow-up was 3.5±2.4 years. Eleven patients took aspirin for 6 months post closure, and one took it for 18 months. Neither coronary thrombosis nor interventional complications were found. Left ventricular ejection fraction, cardiothoracic ratio, pulmonary artery pressure, and the diameters of coronary artery lesions decreased post TCC. Conclusions TCC is feasible and safe in proximal and distal/medium-sized CAF patients. Postoperative anticoagulation with aspirin may prevent short- and medium-term thrombosis, but treatment course and safety need to be investigated by further follow-ups.
About author:: 10.7499/j.issn.1008-8830.2015.04.019
Cite this article:
XIAO Yun-Bin,CHEN Zhi,HUANG Xi-Yong et al. Transcatheter closure in various types of congenital coronary artery fistula: a followup study[J]. CJCP, 2015, 17(4): 384-389.
XIAO Yun-Bin,CHEN Zhi,HUANG Xi-Yong et al. Transcatheter closure in various types of congenital coronary artery fistula: a followup study[J]. CJCP, 2015, 17(4): 384-389.
Gowda ST, Forbes TJ, Singh H, et al. Remodeling and thrombosis following closure of coronary artery fistula with review of management: large distal coronary artery fistulato close or not to close?[J]. Catheter Cardiovasc Interv, 2013, 82(1): 132-142.
Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines[J]. Circulation, 2013, 128(16): 1810-1852.
Bartoloni G, Giorlandino A, Calafiore AM, et al. Multiple coronary artery-left ventricular fistulas causing sudden death in a young woman[J]. Hum Pathol, 2012, 43(9): 1520-1523.
[12]
Majidi M, Shahzamani M, Mirhoseini M. Clinical features of coronary artery fistula[J]. J Tehran Heart Cent, 2011, 6(3): 158- 162.
[13]
Jama A, Barsoum M, Bjarnason H, et al. Percutaneous closure of congenital coronary artery fistulae: results and angiographic follow-up[J]. JACC Cardiovasc Interv, 2011, 4(7): 814-821.
[14]
Gowda ST, Latson LA, Kutty S, et al. Intermediate to long-term outcome following congenital coronary artery fistulae closure with focus on thrombus formation[J]. Am J Cardiol, 2011, 107(2): 302-308.
[15]
Latson L. Taking the high road to a coronary artery fistula[J]. Catheter Cardiovasc Interv, 2013, 81(4): 738-739.
[16]
Valente AM, Lock JE, Gauvreau K, et al. Predictors of longterm adverse outcomes in patients with congenital coronary artery fistulae[J]. Circ Cardiovasc Interv, 2010, 3(2): 134-139.
[17]
Khan MD, Qureshi SA, Rosenthal E, et al. Neonatal transcatheter occlusion of a large coronary artery fistula with Amplatzer duct occlude[J]. Catheter Cardiovasc Interv, 2003, 60(2): 282-286.
