Role of hybrid endovascular suite in improving outcomes of surgical ligation of coronary artery fistula.
Coronary artery fistulae are rare congenital or acquired coronary artery anomalies that can lead to significant cardiovascular morbidity and mortality. Surgical ligation has long been utilized in the treatment of these abnormalities. However, there is a high rate of recurrence due to incomplete closure of the fistulae, especially when multiple channels are present. Transcatheter techniques have become an acceptable alternative with good outcomes. Nevertheless, not all fistulae are amenable to the transcatheter approach and surgical repair is the treatment of choice. Intraoperative coronary angiography can improve the outcomes of surgery but has only sparingly been used due to the technical difficulties in a standard operating suite. Hybrid suites are becoming quite common these days with the emergence of procedures such as endovascular stent grafting and percutaneous valves. These suites have a complete imaging set up like a traditional catheterization laboratory and are also full operating suites. This case report discusses the use and potential benefits of performing intraoperative coronary angiography in a dedicated hybrid suite to help guide and ensure complete surgical closure of all fistulous connections.
Division of Cardiovascular Diseases, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
Kelly
K
Steffen
George Trip
GT
Zorn
Peter
P
Tadros
Kamal
K
Gupta
D000293:Adolescent; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008026:Ligation; D009873:Operating Rooms / Q000145:classification* / Q000379:methods; D016896:Treatment Outcome