Coronary arterial fistulas in childhood

Area of Science:

• Cardiology
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Coronary arterial fistulas are abnormal connections between a coronary artery and a heart chamber or great vessel.
• While often asymptomatic, they can lead to serious complications like heart failure and infective endocarditis.

Purpose of the Study:

• To review the clinical presentation, diagnosis, and management of coronary arterial fistulas in a pediatric cohort.
• To evaluate the outcomes of surgical and non-surgical interventions for coronary arterial fistulas.

Main Methods:

• Retrospective review of 16 pediatric patients diagnosed with coronary arterial fistulas between 1976 and 1997.
• Analysis of patient demographics, clinical symptoms, fistula origin, associated cardiac anomalies, diagnostic methods, and treatment outcomes.

Main Results:

• Four out of 16 patients were symptomatic, presenting with heart failure, exertional dyspnea, or infective endocarditis.
• Fistula origins were predominantly from the right or left coronary arteries.
• 10 patients underwent successful corrective surgery without mortality; one had trans-catheter closure, and two experienced spontaneous closure.

Conclusions:

• Coronary arterial fistulas, though rare, are generally treatable with good outcomes.
• Early diagnosis and appropriate management, including surgical or interventional closure, are crucial for favorable results.