title: Pediatric coronary artery fistula: echocardiographic case reports and literature review of treatment strategy.
abstract: BACKGROUND
  Coronary artery fistula (CAF) is a rare cardiac anomaly. Application of transthoracic echocardiography (TTE) is not fully illustrated in pediatric period. Meanwhile, the treatment strategy of CAF is still a controversial issue.
  
  
  METHODS
  Five cases of CAF with different types were presented. We also retrospectively reviewed 32 records of CAF in our institution from May 2001 to January 2015, including cardiac murmurs, symptoms, TTE diagnoses, complications, other anomalies, treatment and outcome. We summarized the most acceptable treatment strategy for pediatric patients. 71.9 % of all (23/32) had murmurs, 15.6 % of all (5/32) had symptoms. 24 patients received surgery or other imaging examination after TTE. 87.5 % of all (21/24) were correctly and accurately diagnosed by echocardiography, including pointing out the origin and outlet of CAF and complication. During the followup of all 32 patients, there was no spontaneous closure, heart failure, infective endocarditis or death case.
  
  
  CONCLUSIONS
  TTE is a useful method that should be considered in the investigation and follow up of pediatric coronary artery fistula. The treatment strategy for pediatric patients should be individuation.
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, 36# Sanhao Street, Shenyang, 110004 China.
authors.forename: Guang
authors.initials: G
authors.lastname: Song
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, 36# Sanhao Street, Shenyang, 110004 China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, 36# Sanhao Street, Shenyang, 110004 China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Ren
authors.affiliation: Department of Ultrasound, Shengjing Hospital of China Medical University, 36# Sanhao Street, Shenyang, 110004 China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiac Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Zhou
keywords: Coronary artery fistula; Echocardiography; Pediatric