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Percutaneous transcatheter occlusion of coronary artery fistulas using detachable balloons
J W Skimming1, I H Gessner, B E Victorica
1Department of Pediatrics and Neurosurgery, University of Florida, College of Medicine, Gainesville 32610-0296, USA.
Insights
Transcatheter coronary artery fistula occlusion using the Debrun system successfully treated three pediatric patients. This latex balloon system offers a safe and effective alternative to surgical ligation for coronary artery fistulas.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Coronary artery fistulas are abnormal connections between a coronary artery and a heart chamber.
- Surgical ligation has been the traditional treatment, but carries risks.
- Transcatheter occlusion offers a less invasive alternative.
Purpose of the Study:
- To evaluate the safety and efficacy of the Debrun system for transcatheter coronary artery fistula occlusion in pediatric patients.
Main Methods:
- Three pediatric patients with coronary artery fistulas underwent occlusion using the Debrun latex balloon system.
- The Debrun system allows controlled balloon delivery, "test occlusions," and flow-directed positioning.
- Fistulas drained into the right atrium or ventricle.
Main Results:
- Successful occlusion of all three coronary artery fistulas was achieved.
- Two patients received a single balloon, while one patient had two balloons placed.
- No local or systemic reactions were observed during a follow-up period of up to 3 years.
Conclusions:
- Detachable balloon occlusion with the Debrun system is a safe and effective alternative to surgical ligation for selected pediatric patients with coronary artery fistulas.
Abstract:
Three pediatric patients underwent successful transcatheter coronary artery fistula occlusion using the Debrun system. This latex balloon system offers several advantages over other occlusion systems. First, the balloon delivery and release is controlled. Second, "test occlusions" can be performed that allow simultaneous balloon inflation, coronary cineangiography, and electrocardiographic monitoring. Third, because the balloons are flow-directed, they are easily positioned in properly chosen locations. Finally, the balloons can be constructed to suit the size of the fistula. In this study, two patients received only one balloon; in the other patient two balloons were placed in the same fistula. All fistulas drained into either the right atrium or ventricle and were successfully occluded. After a follow-up period of up to 3 years, no local or systemic reactions to the balloons were recognized. We conclude that detachable balloon occlusion of coronary artery fistulas is a safe, effective alternative to surgical ligation in selected pediatric patients.