[Coronary-to-pulmonary artery fistulas: a report of three cases]
Murat Biçer1, Murat Yanar, Abdulkadir Ercan
1Uludağ Universitesi Tip Fakültesi Kalp ve Damar Cerrahisi Anabilim Dali, Bursa, Turkey. mbicer23@yahoo.com
Insights
Congenital coronary-to-pulmonary artery fistulas are rare but can cause symptoms. Surgical repair is effective, but complex plexus-like fistulas may require reoperation.
Area of Science:
- Cardiology
- Thoracic Surgery
- Congenital Heart Disease
Background:
- Congenital coronary-to-pulmonary artery fistulas are uncommon cardiac anomalies.
- These fistulas typically present asymptomatically.
Observation:
- Three symptomatic patients (2 male, 1 female; aged 46-53) underwent surgical repair for coronary-to-pulmonary artery fistulas using an epicardial approach.
- Successful repair was achieved in two patients.
- One patient with a plexus-like fistula required reoperation under extracorporeal circulation.
Findings:
- Direct visualization from within the pulmonary artery allowed successful closure of the fistula's distal orifice.
- No complications or symptoms were observed during follow-up periods ranging from six months to four years.
Implications:
- The presence of plexus-like variants in coronary-to-pulmonary artery fistulas should be considered during surgical planning.
- Tailored treatment strategies are essential for managing complex fistula anatomies.
Abstract:
Congenital coronary-to-pulmonary artery fistulas are rare anomalies and they generally have an asymptomatic course. We presented three symptomatic patients (2 men, 1 woman; age range 46 to 53 years) who underwent surgical repair via the epicardial approach for coronary-to-pulmonary artery fistulas. Treatment was successful in two patients. Reoperation in extracorporeal circulation was required in one patient having a plexus-like fistula. The distal orifice of the fistula was closed under direct vision from within the pulmonary artery. No complications or symptoms were seen during the follow-up of patients ranging from six months to four years. During repair of coronary-to-pulmonary artery fistulas, the presence of a plexus-like variant must be kept in mind and the treatment should be planned accordingly.
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