Erişkinlerde Koroner Arter Fistüllerinin Tanısı, Tedavisi ve Uzun Dönem Takibi

Abstract

Coronary artery fistulas (CAFs) are rare anatomic patterns, found in approximately 0.1 to 0.2% of all patients undergoing coronary angiography. They usually occurs congenitally or maybe acquired. Demographic and clinical characteristics and angiographic findings of patients with (CAFs) have been investigated in this study. Efficacy and safety of percutaneous coil embolization of CAFs have also been evaluated. Cardiac catheterization laboratory database have been examined retrospectively. Among 25,746 patients who had undergone coronary angiography between March 2002 and July 2013, we have noted 35 patients (0.13 %) with CAFs. Thirty one patients were included in this study and 4 patients were excluded due to lack of follow up data. Mean age was 55± 10 years and male/female ratio was 1.5. Chest pain was the most frequent symptom of admission and myocardial ischemia was the major sign in patients with isolated coronary artery fistula. Eighteen out of 31 patients had accompanying cardiac disorders. One patient had coexistent atrial septal defect. The most common artery of origin of the fistula was right coronary artery (46.3%) and pulmonary artery was found to be the most frequent region of the fistula drainage (46.3%). Of 24 patients considered for transcatheter closure; coil implantation was successfully performed in 21 patients (87.5%). Complete occlusion was accomplished in 19 patients (79 %) and long term success was 70 %. Procedure related complications were rare and a minority of patients treated with coil embolization experienced recanalization. Our results suggest that percutaneous coil embolization of coronary artery fistula is a safe and effective method for treatment of coronary artery fistula with suitable anatomy.