PMID- 7728300
OWN - NLM
STAT- MEDLINE
DCOM- 19950601
LR  - 20191023
IS  - 0954-6928 (Print)
IS  - 0954-6928 (Linking)
VI  - 5
IP  - 12
DP  - 1994 Dec
TI  - The surgical management of congenital coronary artery fistula.
PG  - 995-1000
AB  - BACKGROUND: Congenital coronary artery fistula (CAF) is a very rare 
      cardiovascular anomaly and only 400 cases have been reported. The purpose of this 
      study was to analyse the experience of surgical treatments in CAF and evaluate 
      the surgical indications, techniques and long-term results. METHODS: A 
      retrospective study reviewing 20,000 cardiovascular surgical cases from 1978 to 
      1993 was carried out, from which 14 patients with CAF were identified and 
      diagnosis was confirmed by both coronary angiography (CAG) and echocardiography. 
      Twelve patients had heart-related symptoms. CAG revealed that fistulous channels 
      arose from the right coronary artery (RCA) in seven patients, and from the left 
      coronary artery (LCA) in six patients. One patient had multiple fistulae, from 
      both RCA and LCA. The surgical managements and late follow-up were assessed. 
      RESULTS: Surgery was performed on 13 patients; one had died before surgery. 
      Cardiopulmonary bypass (CPB) was performed in 11 patients. The presence of 
      coronary aneurysm was treated by reduction plasty of the aneurysm (four 
      patients). Other procedures were coronary artery bypass grafting (CABG; four 
      patients), ventricular septal defect (VSD) and patent ductus arteriosus (PDA) 
      closure (one patient), and one patient had mitral valve replacement. The mean 
      follow-up time was 7.2 years and all symptomatic patients improved their New York 
      Heart Association (NYHA) functional class (average 1.2 classes). Although there 
      were no surgical deaths in our group, one late death (6 months after surgery) was 
      caused by acute myocardial infarction; this resulted in an annual mortality rate 
      of 1%. CONCLUSIONS: Surgical closure of CAF can be recommended because it is a 
      low-risk procedure and leads to good long-term results. The problems with 
      myocardial protection, residual fistula prevention and surgical techniques must 
      be emphasized. For these purposes, special surgical techniques that have been 
      introduced are described.
FAU - Chen, Y
AU  - Chen Y
AD  - Department of Thoracic and Cardiovascular Surgery, Sahlgrenska Hospital, 
      University of Gothenburg, Sweden.
FAU - Belboul, A
AU  - Belboul A
FAU - Roberts, D
AU  - Roberts D
LA  - eng
PT  - Journal Article
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiopulmonary Bypass
MH  - Child
MH  - Coronary Aneurysm/complications/surgery
MH  - Coronary Angiography
MH  - Female
MH  - Fistula/complications/congenital/diagnostic imaging/*surgery
MH  - Heart Defects, Congenital/complications/diagnostic imaging/*surgery
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 1994/12/01 00:00
MHDA- 1994/12/01 00:01
CRDT- 1994/12/01 00:00
PHST- 1994/12/01 00:00 [pubmed]
PHST- 1994/12/01 00:01 [medline]
PHST- 1994/12/01 00:00 [entrez]
AID - 10.1097/00019501-199412000-00006 [doi]
PST - ppublish
SO  - Coron Artery Dis. 1994 Dec;5(12):995-1000. doi: 10.1097/00019501-199412000-00006.