title: Review of an institutional experience of coronary arterial fistulas in childhood set in context of review of the literature.
abstract: Coronary artery fistulas are uncommon in children. We conducted a retrospective review of the case notes of 17 children who presented to our institution with the diagnosis of a coronary fistula since 1970. Their median age was 2.3 years. In five patients, there were associated congenital cardiac anomalies, with four having these as part of the spectrum of tetralogy of Fallot. Surgical correction was performed in nine patients, while in five closure was achieved using percutaneous embolization with coils. No complications or deaths were encountered related to the treatments chosen. In two patients, further procedures were needed to close residual fistulas. The median follow-up was 16 years, and on echocardiography, all fistulas appeared to be successfully closed, albeit that we lost three patients to follow up. We also conducted a review of 426 cases of coronary fistulas reported in children in the English literature. We have compared these findings with our institutional experience.
authors.affiliation: Department of Paediatric Cardiology, Royal Liverpool Children's NHS Trust, Liverpool, UK.
authors.forename: Ralf
authors.initials: R
authors.lastname: Holzer
authors.forename: Robert
authors.initials: R
authors.lastname: Johnson
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ciotti
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.forename: Denise
authors.initials: D
authors.lastname: Kitchiner
mesh_terms: D017677:Age Distribution; D001159:Arterio-Arterial Fistula / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014656:Vascular Surgical Procedures / Q000379:methods*