Surgical treatment of congenital coronary artery fistulas: 27 years' experience and a review of the literature.
OBJECTIVE
A congenital coronary artery fistula (CAF) is a relatively rare congenital anomaly and is defined as an abnormal direct communication between any coronary artery and any of the cardiac chambers. This article reviews our experience over the past 27 years, as well as other literature, and discusses the surgical indications and methods relating to CAF.


METHODS
From 1973, 25 patients aged from 2 to 69 years underwent surgical treatment for congenital CAF. Seventeen patients were diagnosed as isolated CAF. All patients under 19 years of age with isolated CAF were asymptomatic. Twenty fistulas originated from the left coronary artery and 9 from the right. The pulmonary artery was the most dominant drainage site. Four patients among the isolated CAF cases were surgically treated without a cardiopulmonary bypass.


RESULTS
All patients were discharged from hospital without any perioperative complications. Postoperative coronary angiography was done on all patients with only one slightly residual CAF flow. The average follow-up time was 9.6 years and all patients were asymptomatic and doing well.


CONCLUSIONS
Definitive surgical correction is safe and effective, with good results. Therefore, it should be considered even in asymptomatic patients because of the risk of future complications.
Kamiya
Hiroyuki
H
Department of Surgery, Kanazawa University School of Medicine, Japan.
Yasuda
Tamotsu
T
Nagamine
Hiroshi
H
Sakakibara
Naoki
N
Nishida
Satoru
S
Kawasuji
Michio
M
Watanabe
Go
G
D000328:Adult; D000368:Aged; D001158:Arteries / Q000002:abnormalities / Q000601:surgery; D001164:Arteriovenous Fistula / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome