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Percutaneous transcatheter embolization of coronary arteriovenous fistulas
W O Harris1, J C Andrews, D A Nichols
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic Rochester, MN 55905, USA.
Insights
Coronary artery fistulas, abnormal heart vessels, can be successfully closed using minimally invasive transcatheter embolization. This approach offers a safer alternative to surgery for patients with these rare cardiac conditions.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Coronary artery fistulas are rare vascular anomalies, either congenital or acquired, that can lead to serious cardiac complications.
- While surgical repair has been recommended, it carries significant risks.
Observation:
- This report details two cases of coronary artery fistulas.
- The cases highlight the technical challenges associated with percutaneous closure.
Findings:
- Transcatheter embolization is a viable and effective method for obliterating coronary artery fistulas.
- Percutaneous techniques can successfully treat these anomalies, avoiding open-heart surgery.
Implications:
- Minimally invasive transcatheter embolization offers a less morbid alternative to surgical repair for coronary artery fistulas.
- Successful percutaneous treatment spares patients the risks associated with cardiac surgery.
Abstract:
Coronary artery fistulas are infrequently encountered vascular communications that are either congenital or due to cardiac trauma. Most patients with these anomalies are asymptomatic, but late complications can occur and include congestive heart failure, myocardial ischemia, arrhythmias, and endocarditis. Therefore, many investigators have recommended surgical repair, even for asymptomatic patients. Although coronary arteriovenous fistulas pose many challenges to interventional cardiologists, early experiences suggest that these abnormal vessels can be successfully obliterated percutaneously; thus, the patient is spared the risks and morbidity associated with cardiac surgical intervention. Herein we present two cases that illustrate many of the technical issues involved in successful transcatheter embolization of coronary artery fistulas.