title: Percutaneous treatment of congenital coronary arteriovenous fistulas.
abstract: BACKGROUND
  Congenital coronary arteriovenous fistulas (CAVF), although rare, can present as significant hemodynamic lesions necessitating intervention.
  
  
  RESULTS
  Six patients (two males) with congenital coronary arteriovenous fistulas (CAVF) underwent percutaneous transcatheter occlusion. The ages ranged from 4 years to 49 years (mean 20.1 years). The fistulas had their origins from the right coronary artery (two), the left anterior descending coronary artery (two), and the left circumflex coronary artery (two). One of the fistulas drained to the right ventricle, four drained to the right atrium, and the remaining one to the left ventricle (LV). The fistulas were closed using the arterial approach with Cook™ coils in two patients and with nitinol ductal occluders (NDOs) using the venous approach in four patients. One patient developed dissection of the wall of the fistula during attempted closure and had spontaneous occlusion of the fistula. Complete occlusion of the fistulas were achieved in all patients. Complications consisted of migration and embolization of the coils in one patient (later closed successfully with NDO) and myocardial infarction occurring two weeks following successful closure in another patient. At mean follow-up of 39.6 +/- 22.9 months, all patients were asymptomatic and echo-Doppler evaluation revealed no residual fistulae.
  
  
  CONCLUSIONS
  CAVF are very well amenable to percutaneous closure with acceptable morbidity and high success rates.
authors.affiliation: Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. drharikrishnan@hotmail.com
authors.forename: Sivadasanpillai
authors.initials: S
authors.lastname: Harikrishnan
authors.forename: Francis
authors.initials: F
authors.lastname: Bimal
authors.forename: Valaparambil
authors.initials: V
authors.lastname: Ajithkumar
authors.forename: Anil
authors.initials: A
authors.lastname: Bhat
authors.forename: Kavassery Mahadevan
authors.initials: KM
authors.lastname: Krishnamoorthy
authors.forename: Sivasankaran
authors.initials: S
authors.lastname: Sivasubramonian
authors.forename: Thomas
authors.initials: T
authors.lastname: Titus
authors.forename: Jaganmohan
authors.initials: J
authors.lastname: Tharakan
mesh_terms: D000293:Adolescent; D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D055815:Young Adult