Coronary artery fistula: A case series with review of the literature

• Published in: Journal of cardiology Vol. 53; no. 3; pp. 467 - 472
• Main Authors: Raju, Manjunath G., MD, Goyal, Sandeep K., MD, Punnam, Sujeeth R., MD, Shah, Dinesh O., MD, Smith, George F., MD, Abela, George S., MD, FACC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2009
• Subjects: Adult; Angina-pectoris; Arterio-Arterial Fistula - diagnosis; Arterio-Arterial Fistula - therapy; Cardiovascular; Coil embolization; Coronary circulation; Coronary Vessel Anomalies - diagnosis; Coronary Vessel Anomalies - therapy; Diagnosis, Differential; Embolization, Therapeutic; Fistula; Humans; Interventional cardiology; Male; Middle Aged; Pulmonary Artery - abnormalities; Treatment Outcome; Coil embolization; Angina-pectoris; Coronary circulation; Fistula; Interventional cardiology
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2008.09.009

Summary Coronary artery fistula (CAF) is an anomalous connection between a coronary artery and a major vessel or cardiac chamber. Most of the coronary fistulas are discovered incidentally during angiographic evaluation for coronary vascular disorder. The management of CAF is complicated and recommendations are based on anecdotal cases or very small retrospective series. We present three cases of CAF, two of which were symptomatic due to hemodynamically significant coronary steal phenomenon. They underwent successful transcatheter coil embolization, leading to resolution of their symptoms. Percutaneous closure offers a safe and effective way for the management of symptomatic patients. CAFs are rare cardiac anomalies but can give rise to a variety of symptoms because of their hemodynamic consequences or complications. They should be part of cardiac differential diagnosis particularly in patients without other risk factors. Correction of CAF is indicated if the patients are symptomatic or if other secondary complications develop.