eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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4/2023
vol. 19
 
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abstract:
Original paper

Percutaneous interventions of coronary artery fistulas: a single-center experience

Ahmet Hakan Ateş
1
,
Ahmet Kivrak
2
,
Yusuf Ziya Şener
1
,
Gul Sinem Kilic
1
,
Ergun Baris Kaya
1
,
Mehmet Levent Sahiner
1
,
Necla Özer
1
,
Kudret Aytemir
1

  1. Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
  2. Department of Cardiology, Ankara Etlik City Hospital, Ankara, Turkey
Adv Interv Cardiol 2023; 19, 4 (74): 351–358
DOI: https://doi.org/10.5114/aic.2023.133230
Online publish date: 2023/11/25
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Introduction:
Coronary artery fistula (CAF) is a congenital communication between the coronary artery and other vascular structures or cardiac chambers. Percutaneous CAF closure is an emerging alternative to surgery, but long-term outcome data are limited.

Aim:
To review our center’s experience with percutaneous CAF closure methods.

Material and methods:
Patients who were admitted to our department and underwent percutaneous coronary artery fistula intervention between January 2002 and April 2022 due to presence of CAF-related symptoms or complications were retrospectively analyzed. Data were obtained retrospectively from the hospital electronic database.

Results:
A total of 39 patient were included. Mean age was 57.3 ±12.5 years and 23 (59%) patients were male. The most common symptom was angina (69.2%) and 51.2% of the patients were under treatment with at least one anti-anginal agent at admission. The right coronary artery (n = 19) and left anterior descending artery (n = 19) were the most common sites of CAF origin, and the pulmonary artery (n = 22) was the main drainage site. Coil embolization was performed most frequently and occlusion via cyanoacrylate in 3 patients and detachable balloon angioplasty in one patient were preferred. Percutaneous occlusion was achieved in 34 cases, 2 of the 5 failed cases underwent surgical occlusion, and remaining patients were treated with anti-anginal drugs. Complications occurred in 6 (15.3%) patients and all of the patients recovered without sequelae.

Conclusions:
Coronary artery fistulas may present with different symptoms or complications and there are several techniques for percutaneous occlusion. Percutaneous closure of CAF is feasible and safe in anatomically suitable vessels, with good results at follow-up.

keywords:

coil embolization, coronary artery fistula, percutaneous coronary artery fistula occlusion
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