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Endocarditis of a congenital coronary fistula in a child

Thomas Krasemann1, Ingrid M van Beynum1, Ingrid M E Frohn-Mulder1

  • 1Sophia Kinderziekenhuis,Department of Pediatric Cardiology,Erasmus Medical Centre Rotterdam,Rotterdam,The Netherlands.

Cardiology in the Young
|September 12, 2017
PubMed

Insights

Congenital coronary fistulas are rare in children. This case highlights endocarditis in a 9-year-old boy with a right coronary artery fistula, successfully treated with antibiotics and interventional closure.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Interventional Cardiology

Background:

  • Congenital coronary artery fistulas (CCAFs) are rare vascular anomalies.
  • Endocarditis complicating CCAFs is exceptionally uncommon, particularly in pediatric patients.
  • This case presents a unique instance of CCAFs in a child.

Observation:

  • A 9-year-old boy presented with a fistula originating from a dilated right coronary artery.
  • The fistula connected the coronary artery to the junction of the superior vena cava and right atrium.
  • The patient developed infective endocarditis, a rare complication of this anomaly.

Findings:

  • The patient received a 6-week course of antibiotics to manage the endocarditis.
  • Interventional closure of the coronary fistula was performed 3 months after initial treatment.
  • An Amplatzer vascular plug was successfully used for the fistula closure.

Implications:

  • This case underscores the importance of considering endocarditis in pediatric patients with CCAFs.
  • Successful interventional closure demonstrates a viable treatment option for complex CCAFs.
  • Early diagnosis and management are crucial for favorable outcomes in pediatric patients with CCAFs.

Keywords:
Coronary artery fistulachildendocarditisinterventional treatment

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