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[Congenital coronary fistula. Clinical presentation in 7 cases and literature review]

Alfa Larissa Nava-Oliva1, Felipe David-Gómez, Arturo Martínez-Sánchez

  • 1Servicio de Cardiopatías Congénitas, Hospital de Cardiología, Centro Médico Nacional Siglo XXI (CMN Siglo XXI), Instituto Mexicano del Seguro Social, México, D.F. México.

Archivos De Cardiologia De Mexico
|September 3, 2009
PubMed

Insights

Congenital coronary artery fistulas present differently in children and adults. Coronary angiography is key for diagnosis, and surgical treatment offers low risks for these uncommon cardiac anomalies.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Adult Congenital Heart Disease

Background:

  • Congenital coronary artery fistulas are rare cardiac anomalies.
  • These fistulas can mimic various cardiac conditions.
  • Clinical presentations differ significantly between pediatric and adult patients.

Observation:

  • A study reviewed 7 cases of coronary artery fistulas diagnosed via selective coronariography between 2000 and 2007.
  • Four pediatric cases (mean age 6.5 years) and three adult cases (mean age 25.6 years) were analyzed.
  • Fistula origins and terminations varied, with different patterns observed in children versus adults.

Findings:

  • In children, fistulas originated from the left coronary artery (3 cases) or right coronary artery (1 case).
  • In adults, all fistulas originated from the right ventricle.
  • Successful surgical repair was achieved in two children, with long-term asymptomatic outcomes. One adult patient developed a myocardial infarction post-surgery.

Implications:

  • Clinical and hemodynamic features of coronary artery fistulas are age-dependent.
  • Coronary angiography remains the gold standard for diagnosing these anomalies.
  • Surgical intervention for coronary artery fistulas is associated with low mortality and morbidity rates.
Abstract

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