[Congenital coronary fistula. Clinical presentation in 7 cases and literature review].
Congenital coronary artery fistulas are uncommon anomalies, however themselves may resemble the whole spectrum of cardiac manifestations. Clinical presentations vary considerably from adults to children.


METHODS
patients with coronary artery fistula diagnosed by selective coronariography in the period from 2000 to 2007 were included.


RESULTS
7 cases were found, 4 children, mean age 6.5 years, and 3 adults, mean age 25.6 years. The fistulae originate from the left coronary artery in 3 children, 2 connect to the pulmonary artery an one to the right atrium, in one child the fistula originated from the right coronary artery and terminated at the right ventricle. In the 3 adult patients, the fistula originated from the right ventricle, two connected to the right ventricle and one to the coronary sinus. Two children were operated on successfully and are asymptomatic 1 and 4 years later. In an adult patient with surgical ligation was performed, 4 weeks later developed an uncomplicated myocardial infarction. We reviewed the literature available and were compared with our cases.


CONCLUSIONS
The clinical manifestations and hemodynamic features differ in childhood and adulthood. Coronary angiography is the primary diagnostic tool. Surgical treatment has low mortality and morbidity.
Nava-Oliva
Alfa Larissa
AL
Servicio de Cardiopatías Congénitas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI (CMN Siglo XXI), Instituto Mexicano del Seguro Social, México, D.F. México.
David-Gómez
Felipe
F
Martínez-Sánchez
Arturo
A
Ortegón-Cardeña
José
J
Jiménez-Arteaga
Santiago
S
López-Gallegos
Diana
D
Yáñez-Gutiérrez
Luceli
L
Riera
Carlos
C
Alva
Carlos
C
D000328:Adult; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D016157:Vascular Fistula / Q000151:congenital* / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult