Coronary artery fistulas: how to manage them.
Coronary artery fistulas are rare persisting vascular connections from a coronary artery to a cardiac chamber or major central blood vessel. The true incidence is difficult to discern because at least 75% may be asymptomatic and clinically undetectable until an echocardiogram or coronary arteriogram is performed. Small coronary artery fistulas that are not clinically detectable are not clearly associated with significant long term complications. Medium or large fistulas are associated with significant long term problems including angina, arrhythmias, myocardial infarction, endocarditis, and progressive dilation. Treatment options include surgical and catheter approaches to significant fistulas. The long term outlook after fistula closure is not well defined and deserves further study.
Latson
Larry A
LA
Cleveland Clinic, Center for Pediatric and Congenital Heart Diseases, Cleveland, Ohio 44195, USA. latsonl@ccf.org
D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D003327:Coronary Disease / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004621:Embolization, Therapeutic; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*