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Closure of a coronary fistula with a transcatheter implantable coil
M van den Brand1, H Pieterman, H Suryapranata
1Department of Cardiology, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Insights
Large coronary artery fistulas are rare. A minimally invasive technique successfully closed a left coronary artery fistula draining into the right atrium using a trefoil coil.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Large coronary artery fistulas are uncommon, affecting only 0.05% of adult catheterized patients.
- Surgical intervention for these fistulas is infrequent.
- Coronary artery fistulas can lead to significant cardiovascular complications if left untreated.
Observation:
- A 30-year-old male patient presented with a large left coronary artery fistula draining into the right atrium.
- The fistula's size and location posed a clinical challenge for traditional management.
- Percutaneous closure was considered as a less invasive alternative.
Findings:
- A novel percutaneous technique was successfully employed to close the fistula.
- A trefoil coil was deployed via catheter-based intervention, selectively targeting the fistula.
- The procedure resulted in complete closure of the left coronary artery fistula.
Implications:
- This percutaneous approach offers a viable and less invasive treatment option for large coronary artery fistulas.
- The successful use of a trefoil coil demonstrates its efficacy in managing complex coronary artery fistulas.
- This technique may expand treatment possibilities for patients with coronary artery fistulas, potentially reducing the need for open-heart surgery.
Abstract:
Large sized coronary artery fistulas are rare and diagnosed in only 0.05% of adult catheterized patients. Only a minority of these fistulas are operated upon. We describe a percutaneous technique to close a left coronary artery fistula draining into the right atrium in a 30-yr-old male patient. The fistula was closed by implantation of a trefoil coil, inserted through a catheter selectively advanced into the fistula.