Transcatheter closure of congenital coronary artery fistulae: immediate and long-term follow-up results.
BACKGROUND
Transcatheter closure of coronary artery fistulae (CAF) has emerged as an alternative to surgery, but there are no long-term outcome results.


OBJECTIVE
We report immediate and long-term results in 24 patients after transcatheter closure of congenital CAF.


METHODS
A total of 24 patients aged 5 to 56 years old with congenital CAF underwent attempted percutaneous transcatheter closure using various devices between November 1998 and August 2008. The immediate closure results and clinical follow-up were reviewed.


RESULTS
Of the 24 patients, 20 (83.3%) underwent successful transcatheter closure using various devices. An angiogram right after device deployment revealed complete occlusion in 15 patients (75%) and trivial- to mild- residual flow in 5 patients (25%). Four patients (20%) had transient ST-T wave changes after the procedure. The left ventricular end-diastolic volume decreased from 165+/-31.4 mm3 to 128.6+/-24.4 mm3 (P = 0.012) 24 hours after procedure, and the cardiothoracic ratio from 0.57+/-0.02 to 0.53+/-0.01 (P = 0.003). Follow-up was 100% complete and ranged from 3 months to 10 years. There were no early or late deaths. All patients were asymptomatic with complete closure of CAF except 1 patient (5%) who had a recurrence of shunt at 6-month follow-up, which was re-closed by percutaneous technique.


CONCLUSIONS
Transcatheter closure of CAF is feasible and safe in anatomically suitable vessels and is a promising alternative to surgery in most patients.
Zhu
Xian-Yang
XY
Department of Congenital Heart Disease, Northern Hospital, Shenyang, People's Republic of China. xyangz@yahoo.com.cn
Zhang
Duan-Zhen
DZ
Han
Xiu-Min
XM
Cui
Chun-Sheng
CS
Sheng
Xiao-Tang
XT
Wang
Qi-Guang
QG
Cha
Yong-Mei
YM
Abhiram
Prasad
P
Rihal
Charanjit S
CS
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000151:congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000151:congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left; D055815:Young Adult