Percutaneous embolization of a congenital aortocaval fistula--clinical case

Congenital aortocaval fistulae are a rare cause of left-to-right shunt. In this clinical case, an 8-year-old child was referred by the family doctor for pediatric cardiology consultation after detection of a chest murmur. Cardiac auscultation revealed a continuous murmur, best heard on the left sternal edge and back. During the study, cardiac angiography showed a large collateral vessel in the middle third of the thoracic aorta with a complex and sinuous route that ended at the superior vena cava. Percutaneous embolization was performed using a coil. Due to the large size of the collateral a total of three coils were necessary for complete occlusion. No complications were recorded and six-month follow-up confirmed absence of shunt. Compared to the surgical option, this procedure is less invasive and apparently with less risk to the patient.