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Diagnostic and therapeutic approach of congenital solitary coronary artery fistulas in adults: Dutch case series and review of literature.
MedLine Citation:
PMID:  22020997     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Coronary artery fistulas (CAFs) are infrequent anomalies, coincidentally detected during coronary angiography (CAG).
AIM: To elucidate the currently used diagnostic imaging modalities and applied therapeutic approaches.
MATERIALS AND METHODS: Five Dutch patients were found to have CAFs. A total of 170 reviewed subjects were subdivided into two comparable groups of 85 each, treated with either percutaneous 'therapeutic' embolisation (PTE group) or surgical ligation (SL group).
RESULTS: In our series, the fistulas were visualised with several diagnostic imaging tests using echocardiography, multidetector computed tomography, and CAG. Four fistulas were unilateral and one was bilateral; five originated from the left and one originated from the right coronary artery. Among the reviewed subjects, high success rates were found in both treatment groups (SL: 97% and PTE: 93%). Associated congenital or acquired cardiovascular disorders were frequently present in the SL group (23%). Bilateral fistulas were present in 11% of the SL group versus 1% of the PTE group. The fistula was ligated surgically in one and abolished percutaneously in another. Medical treatment including metoprolol was conducted in two, and watchful waiting follow-up was performed in one.
CONCLUSIONS: Several diagnostic imaging techniques are available for assessment of the anatomical and functional characteristics of CAFs.
S A M Said; R L G Nijhuis; J W Op den Akker; G P Kimman; K G Van Houwelingen; D Gerrits; A B Huisman; R H J A Slart; D M Nicastia; E M Koomen; A C Tans; N Y Y Al-Windy; U Sonker; T Slagboom; A C B Pronk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation     Volume:  19     ISSN:  1876-6250     ISO Abbreviation:  Neth Heart J     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095458     Medline TA:  Neth Heart J     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  183-91     Citation Subset:  -    
Department of Cardiology, ZGT location Hengelo, Geerdinksweg 141, 7555 DL, Hengelo, the Netherlands,
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