Related Experiment Video
Updated: Jul 15, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Percutaneous coronary artery fistula closure in adults: technical and procedural aspects
Nicholas Collins1, Rohit Mehta, Lee Benson
1Toronto Congenital Cardiac Centre for Adults, University Health Network/Toronto General Hospital, Toronto, Ontario, Canada.
Insights
Transcatheter closure effectively treats adult coronary artery fistulae (CAF), an uncommon heart defect. This minimally invasive approach offers a safe solution for symptomatic patients, despite challenges like vessel anatomy.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Coronary artery fistulae (CAF) are rare congenital anomalies involving abnormal connections between coronary arteries and heart chambers.
- Symptomatic CAF often present in adulthood, with limited data on adult transcatheter closure techniques.
Purpose of the Study:
- To describe the experience and procedural aspects of transcatheter fistula closure in adult patients with CAF.
- To evaluate the safety and efficacy of percutaneous closure for symptomatic adult CAF.
Main Methods:
- Retrospective analysis of 14 adult patients undergoing transcatheter CAF closure between 1990 and 2006.
- Emphasis on procedural features, device delivery, and management of anatomical limitations.
Main Results:
- Procedural success was achieved in 11 out of 14 adult patients.
- Vessel tortuosity and narrow lumen caliber were identified as key limitations for device delivery.
- Complications included vessel dissection and device embolization, highlighting potential risks.
Conclusions:
- Transcatheter occlusion is a safe and effective therapeutic option for symptomatic adult patients with coronary artery fistulae.
- Percutaneous closure demonstrates feasibility in an adult population, despite anatomical challenges.
Background:
Coronary artery fistulae (CAF) are an uncommon congenital anomaly characterized by an abnormal connection between the coronary arteries and cardiac chambers or vessels without traversing the usual capillary network. CAF are associated with a number of well-described symptomatic sequelae, which may necessitate treatment. With a tendency for symptoms to develop over time, symptomatic CAF may present for the first time in adulthood, with limited data existing on the technical aspects related to transcatheter fistula closure in adults.
Methods:
We describe our experience in percutaneous closure of CAF in an exclusively adult population, with an emphasis on the various procedural features of device closure in this patient group.
Results:
Attempted transcatheter CAF closure was performed in 14 patients between 1990 and 2006. Procedural success was achieved in 11 patients, with vessel tortuosity and lumen caliber important limitations in occlusion device delivery. Procedural complications included vessel dissection and device embolization.
Conclusion:
Transcatheter occlusion is a safe and effective method of therapy for symptomatic adults with CAF.
Related Concept Videos
01:24Cardiac Catheterization III: Left Heart Catheterization
01:28Cardiac Catheterization I: Pre-Procedure Overview