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Long-term results of surgery for coronary artery fistulas
1Department of Thoracic and Cardiovascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Insights
Surgery for coronary artery fistula (CAF) offers excellent long-term results with no mortality. Surgical intervention is recommended for all patients to prevent potentially fatal complications.
Area of Science:
- Cardiology
- Cardiac Surgery
- Congenital Heart Disease
Background:
- Coronary artery fistula (CAF) is a rare anomaly where a coronary artery connects abnormally to a heart chamber or major vessel.
- Congenital CAF accounts for the vast majority of cases, often diagnosed in adulthood.
- Untreated CAF can lead to severe complications including heart failure, myocardial infarction, and arrhythmias.
Purpose of the Study:
- To report the long-term surgical outcomes for patients with coronary artery fistula.
- To evaluate the safety and efficacy of surgical correction for CAF.
- To assess the recurrence rates and long-term resolution of symptoms post-surgery.
Main Methods:
- A retrospective review of 12 patients who underwent surgical correction for CAF.
- Diagnosis confirmed via coronary angiography, identifying single or multiple fistulous tracts.
- Surgical repair performed predominantly using cardiopulmonary bypass.
Main Results:
- Follow-up ranged from 1 to 15 years post-surgery.
- All patients, except one, underwent cardiopulmonary bypass with zero mortality.
- Complete symptom resolution and no fistula recurrence were observed in all surgically treated patients.
Conclusions:
- Surgical correction of coronary artery fistula is a safe and highly effective procedure.
- Excellent long-term results and absence of recurrence support surgical intervention.
- Early surgical management is recommended to prevent life-threatening cardiovascular complications associated with CAF.
Abstract:
This report describes our long-term result of surgery for coronary artery fistula in 12 patients. Follow-up range was from one year to 15 years, and with one exception they were all congenital in origin. Diagnosis was confirmed with angiography in all cases, showing single fistulous tract in four patients and multiple in eight patients. All but one patient were operated on by cardiopulmonary bypass with no mortality and with complete resolution of symptoms and no recurrence of the fistula. We conclude that surgery for coronary artery fistula can be accomplished safely with excellent long-term results and should be recommended for all patients to prevent life-threatening complications that may develop.