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Congenital coronary artery-left heart fistulas: Report of three cases

A Thomas Pezzella1, Giorgio Falaschi, David A. Ott

  • 1Department of Cardiovascular Surgery of the Texas Heart Institute, Houston, Texas.

Cardiovascular Diseases
|September 1, 1981
PubMed

Insights

Surgical correction of congenital coronary artery fistulas terminating in the left heart is effective. Early elective ligation in childhood is recommended, even for asymptomatic patients, to prevent future complications.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Congenital coronary artery fistulas are rare cardiac malformations.
  • Fistulas terminating in the left heart present unique surgical challenges.
  • Complications include rupture, endocarditis, and congestive heart failure, often age-related.

Purpose of the Study:

  • To evaluate the surgical outcomes of congenital coronary artery fistulas terminating in the left heart.
  • To emphasize the importance of timely surgical intervention.
  • To support the recommendation for early elective ligation.

Main Methods:

  • Review of 59 patients undergoing operative correction for congenital coronary artery fistulas.
  • Focus on three cases with fistulas originating from a coronary artery and terminating in the left heart.
  • Analysis of pre- and post-operative patient symptoms and complications.

Main Results:

  • Three patients with left heart terminating fistulas underwent successful operative correction.
  • All three symptomatic patients became asymptomatic after surgical repair.
  • The findings support the efficacy of surgical intervention for these specific fistulas.

Conclusions:

  • Operative correction of congenital coronary artery fistulas terminating in the left heart yields favorable outcomes.
  • Early elective ligation during childhood is crucial, even in asymptomatic cases, to prevent age-related complications.
  • Timely surgical management is essential for improving long-term prognosis in affected children.

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