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[Percutaneous closure of a giant coronary artery fistula draining into superior vena cava]
Ana Lebreiro1, Teresa Pinho, João Carlos Silva
1Serviço de Cardiologia, Hospital de São João, Porto, Portugal. ana.lebreiro@gmail.com
Insights
This study reports the successful percutaneous closure of a large coronary artery fistula in an adult using an Amplatzer Vascular Plug. This demonstrates a safe and effective treatment option for adult patients with coronary artery fistulas.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Anomalies
Background:
- Coronary artery fistulas are rare congenital heart abnormalities.
- Coronary angiography is the standard diagnostic tool and guides intervention.
- Percutaneous closure of coronary fistulas using Amplatzer Vascular Plugs has shown success in pediatric patients.
Observation:
- A 36-year-old female presented with a large right coronary artery fistula draining into the superior vena cava.
- The fistula was unusually large, and the patient was asymptomatic.
- Management of large, asymptomatic fistulas remains a topic of discussion.
Findings:
- Successful percutaneous closure of the large coronary artery fistula was achieved.
- A 14 mm Amplatzer Vascular Plug II (AGA) device was utilized for the closure.
- This represents the first reported case of successful percutaneous closure of a coronary fistula in an adult patient using this device.
Implications:
- Percutaneous closure with Amplatzer Vascular Plugs is a viable and effective treatment for adult coronary artery fistulas.
- This technique offers a minimally invasive alternative to surgical intervention.
- Further research may support the routine use of this device for managing coronary fistulas in adults.
Abstract:
Coronary artery fistulas are rare coronary anomalies; coronary angiography remains the gold standard for the diagnosis, and is essential to plan either surgical or percutaneous intervention. The use of an Amplatzer Vascular Plug device in percutaneous closure of coronary fistulas has been recently described in a few cases of paediatric age patients, with positive results, but has never been reported in adult patients. We report the case of a 36-year-old female, with an unusually large right coronary artery fistula draining into superior vena cava that was successfully closed percutaneously, using a 14 mm Amplatzer device (Vascular Plug II, AGA). We also discuss our therapeutic option, since management of large, asymptomatic fistulas, is still a matter of debate, although most authors tend to recommend its closure.
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