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Coil embolization therapy in congenital coronary arterial fistulas
A Eicken1, W Sebening, Th Genz
1Department of Pediatric Cardiology, German Heart Center, Technical University, Munich, Lazarettstrasse 36, D-80686 Munich, Germany.
Insights
Congenital coronary arterial fistulas in children were successfully treated with coil occlusion. This minimally invasive technique effectively closed abnormal connections to the right side of the heart in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Congenital coronary arterial fistulas are rare heart defects.
- These abnormal connections can lead to significant hemodynamic issues in children.
Observation:
- Three pediatric patients, aged 8.5 years, 3 years, and 1 month, presented with congenital coronary arterial fistulas.
- Fistulas drained into the main pulmonary artery (1) or right ventricle (2).
- Complex cases included open ductus arteriosus and pulmonary atresia with intact ventricular septum.
Findings:
- All congenital coronary arterial fistulas were successfully managed with transcatheter coil occlusion.
- Angiocardiography confirmed complete fistula occlusion in all cases.
- One patient required simultaneous closure of a fistula and patent ductus arteriosus.
Implications:
- Coil occlusion offers a minimally invasive and effective treatment for pediatric coronary fistulas.
- Successful management can prevent complications associated with right-sided heart shunting.
- This approach is suitable for complex congenital heart anomalies involving coronary fistulas.
Abstract:
Three pediatric patients (8.5 years, 3 years, and 1 month) presented with congenital coronary arterial fistulas. In all cases the fistulas entered into the right side of the heart (main pulmonary artery, n = 1; right ventricle, n = 2). In the first patient, the fistula and an open ductus arteriosus were closed during the same intervention. The second patient presented with a single left coronary ostium and residual shunt from the coronary artery system to the right ventricle after surgery. The third child had pulmonary atresia with intact ventricular septum and a fistula from the left coronary artery to the right ventricle. The fistulas in all patients were managed with coil occlusion. Fistula occlusion was documented with angiocardiography.