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Coronary artery fistula. Management and intermediate-term outcome after transcatheter coil occlusion
C J McMahon1, M R Nihill, J P Kovalchin
1Lillie Frank Abercrombie Division of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston 77030, USA.
Insights
Transcatheter coil occlusion is a safe therapy for pediatric coronary artery fistulae, avoiding open surgery. However, persistent coronary artery dilatation was observed up to 4 years post-procedure.
Area of Science:
- Pediatric cardiology
- Interventional cardiology
- Congenital heart disease
Background:
- Transcatheter occlusion of coronary artery fistulae offers a minimally invasive alternative to surgery in children.
- This approach avoids cardiopulmonary bypass and median sternotomy, reducing surgical risks.
- Long-term outcomes following transcatheter occlusion are not well-established.
Observation:
- This study reports on the intermediate-term follow-up of 4 pediatric patients who underwent transcatheter coil occlusion for coronary artery fistulae.
- Data were collected up to 4 years after the occlusion procedure.
Findings:
- All 4 patients demonstrated persistent coronary artery dilatation.
- This dilatation was evident as late as 4 years post-intervention.
Implications:
- While transcatheter occlusion is effective and safe in the short term, persistent coronary artery dilatation warrants further investigation.
- Understanding the long-term sequelae of coronary artery dilatation after fistula closure is crucial for patient management.
- Further research is needed to assess the clinical significance and management of persistent dilatation.
Abstract:
During the last 2 decades, transcatheter occlusion of coronary artery fistulae has developed into a safe and effective therapy for children. This procedure avoids the need for open surgical repair and the attendant complications of cardiopulmonary bypass and median sternotomy. The long-term outcome in patients after transcatheter occlusion remains unknown. We describe the intermediate-term progress of 4 such patients after coil occlusion of coronary artery fistulae. Persistent coronary artery dilatation was present in all patients reviewed, as late as 4 years after occlusion.