Related Experiment Videos
Transcatheter embolization treatment of coronary arteriovenous fistulas
1Department of Pediatric Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. uaydogan@turk.net
Insights
Transcatheter coronary arteriovenous fistula occlusion is a successful treatment for children, comparable to surgery. Choosing the right technique can prevent repeat procedures for congenital coronary arteriovenous fistulas.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Congenital coronary arteriovenous fistulas (CAVF) can lead to complications like feeding artery dilation and aneurysms.
- Surgical ligation is a treatment option, but recanalization can occur, necessitating further intervention.
Purpose of the Study:
- To evaluate the efficacy and safety of transcatheter occlusion for congenital coronary arteriovenous fistulas in pediatric patients.
- To compare transcatheter occlusion outcomes with surgical ligation for CAVF.
Main Methods:
- Transcatheter occlusion was performed in 5 children (median age 5.3 years) using detachable balloons or controlled-release coils.
- Previous surgical ligation had failed in one patient due to recanalization.
- Follow-up included assessment of fistula occlusion and potential complications.
Main Results:
- Complete fistula occlusion was achieved in 4 out of 5 patients.
- One patient required multiple attempts, and another experienced mild to moderate aortic valve insufficiency post-procedure.
- Feeding artery dilation was noted in 4 patients, with one also having a coronary artery aneurysm.
Conclusions:
- Transcatheter occlusion of congenital coronary arteriovenous fistulas is a viable and effective treatment in children, with success rates comparable to surgery.
- Optimal technique selection is crucial to minimize the need for repeat procedures and potential complications.
- This minimally invasive approach offers a promising alternative to surgical intervention for pediatric CAVF.
Abstract:
Transcatheter coronary arteriovenous fistula occlusion was performed in 5 children with a median age of 5.3 years (range, 0.7 to 11 years). Surgical ligation had been carried out previously in one case, but recanalization occurred during follow-up. Dilation of the feeding artery was observed in 4 patients, with an additional aneurysm of the coronary artery in one of these. Occlusion was attempted three times in 1 patient, twice in 2, and once in the other 2. Detachable balloons were used in 2 procedures, and controlled-release coils in 3. Complete occlusion of the fistula was achieved in 4 patients. In the 5th patient, occlusion of one of two fistulas was unsuccessful, and mild to moderate aortic valve insufficiency developed due to catheter manipulation. Our experience indicates that transcatheter occlusion of congenital coronary arteriovenous fistula is at least as successful as surgical intervention. Multiple occlusion procedures can be avoided by selecting the optimal technique in each case.