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Antegrade transcatheter closure of coronary artery fistulae using vascular occlusion devices

C A Pedra1, J Pihkala, D G Nykanen

  • 1Department of Pediatrics, Division of Cardiology, The Variety Club Catheterization Laboratories, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.

Heart (British Cardiac Society)
|January 5, 2000
PubMed

Insights

Transcatheter occlusion successfully treated coronary artery fistulae in two children. Antegrade techniques using specific devices effectively closed these abnormal connections to the right ventricle.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Coronary artery fistulae (CAF) are abnormal connections between coronary arteries and heart chambers.
  • While often congenital, CAFs can cause significant hemodynamic issues in pediatric patients.
  • Transcatheter closure is an emerging alternative to surgical intervention for select CAF cases.

Observation:

  • Two pediatric patients, a 9-year-old boy and a 2.5-year-old girl, presented with coronary artery fistulae.
  • These fistulae communicated directly with the right ventricle.
  • The patients were candidates for minimally invasive treatment.

Findings:

  • Successful transcatheter occlusion of the coronary artery fistulae was achieved in both children.
  • An antegrade approach was utilized for device deployment.
  • A Rashkind double umbrella device was used in one patient, and an Amplatzer duct occluder in the other.

Implications:

  • Transcatheter closure represents a safe and effective treatment option for pediatric coronary artery fistulae involving the right ventricle.
  • The antegrade technique offers a viable alternative for device delivery.
  • Further research can explore long-term outcomes and device selection for various CAF anatomies.

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