title: Coronary-cameral fistulas: indications and methods for closure.
abstract: Coronary-cameral fistulas (CCF) are anomalous connections between one or more coronary arteries and a cardiac chamber, most commonly the right ventricle or right atrium. The major indications for closure are: significant left to right shunt, myocardial ischaemia, prevention of endoarteritis or rupture. Nowadays, the first option for treatment is transcatheter closure. According to the morphology of the fistulas the most appropriate occluder device should be selected: coils (e.g., Gianturco coils, controlled-release coils, PFM coils), vascular plugs or a patent ductus arteriosus (PDA) device or muscular ventricular septal defect (VSD) device. The way to deploy the occluders could be direct arterial or venous through an arteriovenous loop, according to the anatomy of the fistulas assessed by multiple angiograms in different projections. A test occlusion of the fistula with balloon catheter and simultaneous coronary angiogram is recommended for choosing the proper device type and size and the best position for deployment to achieve complete occlusion of the fistula without compromising the flow in coronary side branches.
authors.affiliation: Pediatric and Adult Congenital Cardiology - Policlinico San Donato IRCCS, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Carminati
authors.forename: Luca
authors.initials: L
authors.lastname: Giugno
authors.forename: Massimo
authors.initials: M
authors.lastname: Chessa
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Butera
authors.forename: Luciane
authors.initials: L
authors.lastname: Piazza
authors.forename: Claudio
authors.initials: C
authors.lastname: Bussadori
mesh_terms: D003324:Coronary Artery Disease / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D055989:Septal Occluder Device; D016157:Vascular Fistula / Q000601:surgery*