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Transcatheter embolization of recanalized coronary artery fistula with Nit-Occlud device
Sotiria C Apostolopoulou1, Pipina Bonou, Spyridon Rammos
1Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Avenue, Athens, GR 176 74, Greece. riapos@hol.gr
Insights
Recanalization of congenital coronary artery fistula after transcatheter coil occlusion is rare. A novel Nit-Occlud system successfully closed a recanalized fistula, offering a new interventional option.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Congenital coronary artery fistula (CCAF) is a rare cardiac anomaly.
- Treatment options include surgical or interventional closure.
- Recanalization after occlusion is uncommon, particularly after interventional methods.
Observation:
- A patient presented with recanalization of a CCA fistula previously occluded with Gianturco coils.
- Angiography confirmed complete transcatheter occlusion followed by recanalization.
- This is the first reported case of recanalization after interventional closure of a CCA fistula.
Findings:
- The recanalized fistula was successfully managed using a Nit-Occlud system.
- This device, typically used for patent ductus arteriosus closure, proved effective for fistula management.
- Transcatheter approach avoided repeat coil embolization or surgical intervention.
Implications:
- The Nit-Occlud system represents a potential new therapeutic option for managing CCA fistula recanalization.
- This case expands the utility of devices designed for other congenital heart defects.
- Further research is warranted to evaluate the long-term efficacy and safety of this approach.
Abstract:
Congenital coronary artery fistula is a rare anomaly with varying symptomatology that may be addressed with surgical or interventional closure. Recanalization after complete occlusion of a coronary artery fistula has only been reported after surgical but not after interventional closure. We present a case of coronary artery fistula recanalization after angiographically documented complete transcatheter occlusion with Gianturco coils. The fistula was successfully managed by transcatheter implantation of a Nit-Occlud system, originally designed for interventional closure of patent ductus arteriosus.