Coronary artery fistulas
Abstract
Coronary artery fistulas are classified as abnormalities of termination and referred to as major congenital anomalies. Most coronary artery fistulas are small, unaccompanied by clinical symptoms, and diagnosed by echocardiography or coronarography performed for an unrelated cause. Such fistulas usually do not cause any complications and can spontaneously resolve. However, larger fistulas are usually >3 tones the size of a normal caliber of a coronary artery and may give rise to clinical symptoms in these cases. The clinical symptoms of coronary artery fistulas may mimic those of various heart diseases depending on which chamber a fistula drains into. Most fistulas are congenital. Congenital coronary artery fistulas may occur as an isolated malformation or be concurrent with other cardiac anomalies, more frequently with critical pulmonary stenosis or atresia with an intact interventricular septum and pulmonary stenoses, Fallot's tetralogy, aortic coarctation, and left heart hypoplasia. When choosing a treatment modality, one should take into account the number of fistula communications, the feeding vessel, localization of drainage, degree of myocardial damage, and hemodynamic relevance of the shunt caused by the presence of a fistula. The goal of treatment is to obliterate a fistula by preserving normal coronary blood flow. The risk for persisting fistula should be balanced with the potential risk of complications related to a procedure of coronarography and fistula occlusion. Percutaneous transcatheter coil occlusion of coronary artery fistulas is the modality of choice in children with the suitable anatomy of fistula communications and without concomitant congenital heart diseases.
About the Authors
V. M. Subbotin
Irkutsk State Regional Children's Clinical Hospital
Russian Federation
Russian Federation
Yu. M. Belozerov
Irkutsk State Medical Academy of Postgraduate Education
Russian Federation
Russian Federation
L. V. Bregel
Research Clinical Institute of Pediatrics, Moscow
Russian Federation
Russian Federation
References
1. Gowda R.M., Vasavada B.C., Khan LA. Coronary artery fistulas: clinical and therapeutic considerations. Int J Cardiol 2006; 8: 107: 1: 7-10.
2. Ahmad Т., Pasarad A.K., Kishore K.S., Maheshwarappa N.N. Huge aneurysm and coronary-cameral fistula from right coronary branch: First case. Asian Cardiovasc Thorac Ann 2014; PMID: 25249660.
3. Krause W. Uber den ursprung einer accessorischen a. coro-naria aus der a. pulmonalis. Z Ratl Med 1865; 24: 225—227.
4. Biorck G., Crafoord C. Arteriovenous aneurysm on the pulmonary artery simulating patent ductus arteriosus botalli. Thorax 1947; 2: 2: 65-74.
5. Kim K.I., Lee W. Y, Ко LL.LL. et al. Right coronary artery fistula and occlusion causing myocardial infarction after blunt chest trauma. Korean J Thorac Cardiovasc Surg 2014; 47: 4: 402-405.
6. Said S.A., Schiphorst R.H., Derksen R., Wagenaar L.J. Coronary-cameral fistulas in adults: Acquired types (second of two parts). World J Cardiol 2013; 5: 12: 484-494.
7. Sharma U.M., Aslam A.F., Так Т. Diagnosis of coronary artery fistulas: clinical aspects and brief review of the literature. Int J Angiol 2013; 22: 3: 189-192.
8. Schamroth С Coronary artery fistula. J Am Coll Cardiol 2009; 53: 6: 523-533.
9. Awasthy N., Radhakrishnan S., LyerKS., GoelA. Coronary artery fistula to pulmonary artery: coronary-dependent pulmonary circulation. Ann Thorac Surg 2014; 97: 2: 716.
10. Банкл L. Врожденные пороки сердца и крупных сосудов. Пер. с англ. М: Медицина 1980; 312. (Bankl G. Congenital malformations of the heart and great vessels. Translated from English. M: Medicine 1980; 312.)
11. Huhn G., Fassbender £>., Gleichmann U. Congenital arteriovenous fistula of the coronary arteries in adults: 12 personal cases, a review of the literature, discussion of treatment possibilities. Z Kardiol 1989; 78: 7: 435-440.
12. Brussee LL., Gasser R. Coronary Artery Fistula N Engl J Med 2000; 342: 4: 334-342.
13. Oztunc F., Gokalp S., Yuksel M.A. et al. Prenatal diagnosis of left coronary artery to right ventricle fistula. J Clin Ultrasound 2014; doi: 10.1002/jcu.22215.
14. Cetiner N., Altunyuva Usta S., Akalin F. Coronary arteriove-nous fistula causing hydrops fetalis. Case Rep Obstet Gynecol 2014; 2014: 487281. doi: 10.1155/2014/487281.
15. Almeida L., Caetano F., Trigo J. et al. Transthoracic echocar-diography in the diagnosis of coronary fistula. Rev Port Cardiol 2014; doi: 10.1016/j.repc.2014.01.008.
16. Yoon J.Y., Lee S.H. An incidentally detected huge coronary arteriovenous fistula: Comprehensive evaluation using non-invasive imaging modalities. J Cardiovasc Comput Tomogr 2014; 8: 5: 404-406. doi: 10.1016/j.jcct.2014.07.004.
17. Xie M., Li L., Cheng T. O. et al. Coronary artery fistula: Comparison of diagnostic accuracy by echocardiography versus coronary arteriography and surgery in 63 patients studied between 2002 and 2012 in a single medical center in China. Int J Cardiol 2014; doi: 10.1016/j.ijcard.2014.07.198.
18. Feltes T.F., Bacha E., Beekman R.H. et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011; 123: 22: 2607-2652.
19. Hascoet S., Combelles S., Acar P. Cardiac computed tomography of multiple coronary arteries to right ventricle fistulas in a newborn with pulmonary atresia and intact ventricular septum. Can J Cardiol 2014; 30: 2: 247.
20. Shen Y, Li R., Fan Z, Zhang N. Demonstration of coronary artery fistula between the left circumflex coronary artery and right ventricule using echocardiography and multidetector CT Anadolu Kardiyol Derg 2014; doi: 10.5152/akd.2014.5667.
21. YilmazerM.M., DemirF., YolbasL., BiliciM. Spontaneous closure of a symptomatic coronary artery fistula just within a few days of newborn period. Congenit Heart Dis 2014; 9: 1: E27— E30.
22. Wang C, Zhou K, Li Y et al. Percutaneous transcatheter closure of congenital coronary artery fistulae with patent ductus arteriosus occluder in children: focus on patient selection and intermediate-term follow-up results. J Invasive Cardiol 2014; 26: 7: 339-346.
23. Wang S.S., Zhang Z.W., Qian M. Y. et al. Transcatheter closure of coronary arterial fistula in children and adolescents. Pediat Int 2014; 56: 2: 173-179.
24. Reeves E.R., Jahromi B.S., Ling F.S. Coil embolization of a coronary artery to left ventricular fistula using detachable coils. Catheter Cardiovasc Interv 2013; 82: 1: 155-158.
25. Kasar P., Kotecha M., Vimala J. et al. Management of coronary artery fistulas in current era. Ann Pediat Cardiol 2010; 3: 224-225.
26. Wang J.K., Wu M.H., Ling M.T., Chiu S.N. Transcatheter treatment of coronary artery fistula using a variety of devices. Cardiol Young 2010; 20: 400-401.
27. Wiegand G., Sieverding L., Kaulitz, Я., Hofbeck M. Transar-terial and transvenous approach for transcatheter closure of a large coronary artery fistula with the Amplatzer vascular plug. Pediat Cardiol 2009; 30: 2: 172-175.
28. Бокерия Л.А., Бокерия О.Л., Биниашвили М.Б. и др. Опыт лечения врожденных коронарно-сердечных фистул в сочетании с нарушениями ритма сердца. Анналы арит-
29. мологии 2013; 1: 52—60. (Boqueria L.A., BoqueriaO.L., Biniashvili M.B. et al. Experience in the treatment of congenital coronary heart fistula combined with cardiac arrhythmias. Annaly aritmologii 2013; 1: 52—60.)
30. Sugawara M., Oguma F., Hirahara H. Pediatric case of congenital coronary artery fistula;surgical result and late changes in coronary artery aneurysm. Kyobu Geka 2014; 67: 7: 544— 548.
31. HernandezM., Carretero J.M., Prada F. Propranolol as a treatment for multiple coronary artery micro-fistulas. Cardiol Young 2014; 24:1-4.
Review
For citations:
Subbotin V.M., Belozerov Yu.M., Bregel L.V. Coronary artery fistulas. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2015;60(1):16-22. (In Russ.)
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