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Updated: Aug 17, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Covered stent for closure of symptomatic plexus-like coronary fistula
Insights
Congenital coronary artery fistulas can cause serious heart problems. A new technique using a PTFE-covered stent successfully treated a complex, plexus-like fistula causing myocardial ischemia.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Coronary artery fistulas are the most common congenital coronary anomalies.
- Symptomatic fistulas require treatment to prevent sudden death or myocardial infarction.
- Surgical closure is standard, but interventional cardiology offers an alternative.
Observation:
- Plexus-like fistulas, with multiple tortuous branches, present treatment challenges.
- A patient presented with a plexus-like coronary to pulmonary artery fistula causing myocardial ischemia.
- The fistula was not associated with atherosclerosis.
Findings:
- A polytetrafluoroethylene-covered (PTFE) stent was successfully used to close the fistula.
- This interventional approach provided a safe and efficient treatment option.
- The patient's myocardial ischemia was resolved.
Implications:
- PTFE-covered stents are a viable option for complex coronary artery fistulas.
- Interventional cardiology can effectively manage challenging congenital coronary anomalies.
- This technique may reduce the need for open-heart surgery in select cases.
Abstract:
Coronary to pulmonary artery fistula are the most frequent congenital anomalies of the coronary arteries. When they are symptomatic they have to be treated in order to prevent complications such as sudden death or myocardial infarction. Surgery is the gold standard for their closure. However an increasing number of reports have shown that interventional cardiology could be a safe and efficient alternative. Plexus-like fistula are composed of multiples and tortuous branches that make them difficult to treat. We report the use of polytetrafluoroethylene-covered (PTFE) stent to cure a plexus-like coronary to pulmonary artery fistula, without associated atherosclerosis, responsible for myocardial ischemia.
