Are discrete coronary artery fistulae different from coronary arteriovenous malformations?
OBJECTIVE
To delineate whether coronary arteriovenous malformations have different properties than classical discrete coronary artery fistulae.


METHODS
Group 1 included 17 patients with discrete coronary fistula that represents a coronary artery fistula draining into any cardiac chamber. Group 2 included six patients with coronary arteriovenous malformations representing extensive coronary artery malformation. Cardiopulmonary bypass was used in 12 of the Group 1 patients and 5 in Group 2.


RESULTS
There was no operative mortality in either group. Following a hemodynamically nonsignificant residual fistulous communication, which was detected by repeat coronary angiography in Group 2; we changed our surgical technique of suture ligation on beating heart. Then we preferred pulmonary arteriotomy and sutured the orifice of coronary arteriovenous malformations from within the chamber.


CONCLUSIONS
Coronary arteriovenous malformations have different morphology and also complex progression properties when compared with discrete coronary artery fistulae. Surgical repair of coronary arteriovenous malformation should be done by suturing the multiple drainage holes inside the draining chamber. Suture ligation of coronary arteriovenous malformation is difficult due to the fragile vessel.
Demirkilic
Ufuk
U
Gulhane Military Medical Academy, Department of Cardiovascular Surgery, Etlik, Ankara, Turkey. udemirk-lilic@gata.edu.tr
Gunay
Celalettin
C
Bolcal
Cengiz
C
Doganci
Suat
S
Cingoz
Faruk
F
Kuralay
Erkan
E
Tatar
Harun
H
D000293:Adolescent; D000328:Adult; D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies