Surgical treatment of coronary-to-pulmonary fistula: how and when?
Francesco Onorati1, Pasquale Mastroroberto, Massimo Bilotta
1Cardiac Surgery Unit, University of Magna Graecia, Catanzaro, Italy. franokono@libero.it
Insights
Coronary arteriovenous fistulas (CAVF) are rare heart conditions. Surgical closure of CAVF is safe and effective, with no operative complications and excellent long-term outcomes for patients.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Vascular Surgery
Background:
- Coronary arteriovenous fistulas (CAVF) are uncommon congenital heart defects.
- Treatment strategies for asymptomatic CAVF remain debated.
- This study focuses on the surgical management of CAVF.
Observation:
- Four patients with CAVF were surgically treated over one year.
- Three patients had concurrent cardiac anomalies.
- CAVF was identified and repaired using running sutures in all cases.
Findings:
- Surgical closure of CAVF resulted in no operative mortality or morbidity.
- All patients remained asymptomatic during follow-up.
- Associated CAVF should be addressed during cardiac surgery.
Implications:
- Surgical intervention for CAVF is a safe and effective treatment.
- Early identification and closure of CAVF are crucial.
- This approach ensures favorable long-term outcomes for patients with CAVF.
Abstract:
Coronary arteriovenous fistulas (CAVF) are rare malformations. Opinions vary on which operation should be offered to these patients, particularly those asymptomatic. We report four patients operated on for CAVF referred to our institution over the course of a year. Three patients had associated cardiac lesions. In all of them CAVF was identified and closed with running sutures. There was no operative mortality or operative morbidity. All patients were asymptomatic at follow-up. In patients undergoing surgical treatment of cardiac disease, associated CAVF should always be treated. Although in patients with giant CAVF it is safer to patch the outflow of CAVF from the outflow chamber, in the majority of cases CAVF should be identified intraoperatively and closed with multiple running stitches.
