| Congenital coronary fistulas in children and adults: diagnosis, surgical technique and results. | |
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MedLine Citation:
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PMID: 8793168 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Coronary artery fistula is a very rare congenital malformation with an abnormal coronary-cameral communication that may involve any chamber and any or all coronary artery branches. We present our experience with 11 consecutive patients (mean age 16.6 years, ranging from 4 to 64 years); 9 of them were treated surgically, spontaneous closure of the fistula was observed in 1 patient and 1 patient is still under observation. Nine patients were under 17 years of age at the time of operation whereas only 2 patients were older (56 and 64 years). Fistulas originated from the right coronary artery in 4 patients and drained either into the right (n = 3) or into the left system (n = 1). In 8 patients, the origin of the coronary artery from the aorta was normal and the fistulous communications developed with the right cardiac structures only. In 2 patients, both coronary arteries were involved in the pathological drainage and 2 patients were demonstrated to have multiple drainage from the left coronary artery. Additional congenital cardiac malformations were found in 2 patients: severe tricuspid valve regurgitation in 1 and ventricular septal defect in another patient. Surgical closure of the fistula was successful in all operated patients (in 1 case treatment was possible without cardiopulmonary bypass). Simple ligation of the fistula was performed in 1 patient, intracardiac closure of the fistula was combined with different reconstructive procedures in the other patients. No hospital mortality nor severe complications occurred in this small group of patients. The mean follow-up interval was 39.4 months and all patients were in NYHA functional class I, except 1 with moderate tricuspid and mitral valve regurgitation. In the presence of symptoms of congestive heart failure, significant left-to-right shunt and arrhythmias, elective closure of coronary fistula is generally accepted, whereas the indication is more controversial in asymptomatic patients. Considering the low perioperative morbidity, we recommend surgical closure of coronary fistulas with significant shunt and/or increased coronary artery diameter. |
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Authors:
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T Carrel; T Tkebuchava; R Jenni; U Arbenz; M Turina |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiology Volume: 87 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 1996 Jul-Aug |
Date Detail:
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Created Date: 1996-11-13 Completed Date: 1996-11-13 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 325-30 Citation Subset: IM |
Affiliation:
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Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Arterio-Arterial Fistula / congenital*, diagnosis, surgery Child Child, Preschool Coronary Angiography / methods Coronary Disease / congenital*, diagnosis, surgery Coronary Vessel Anomalies / diagnosis*, surgery* Echocardiography, Doppler, Color / methods Female Follow-Up Studies Humans Male Middle Aged Postoperative Complications Retrospective Studies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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