Surgical Treatment of Congenital Coronary Artery Fistula_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LU Zirun , CHEN Xin , XU Ming , JIANG Yingshuo , QIU Zhibing , WANG Rui.

Department of Thoracic and Cardiovascular Surgery，Nanjing First Hospital，Nanjing Medical University，Nanjing 210000，P. R. China;

Corresponding author：

Keywords：

Congenital heart disease; 　Coronary artery fistula; 　Surgery

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Abstracts：　Objective　To summarize clinical experience and surgical outcomes of congenital coronary arterial fistula　（CAF）.　Methods　We　retrospectively analyzed clinical records of 12 patients （6 males, 6 females）, aged from 4 to 77 （50.90±23.8） years, who underwent surgical repair of CAF in Nanjing First Hospital between February 2005 and June 2011. There were 3 CAF patients associated with coronary artery aneurysms, one with patent foramen ovale and 2 with coronary artery disease （CAD）. One CAD patient had concomitant severe aortic valve stenosis. One patient underwent　surgical repair without cardiopulmonary bypass （CPB） and 11 patients underwent surgery under CPB, among whom 3 patients underwent surgery with beating heart. One patient underwent concomitant aortic valve replacement and coronary artery bypass grafting.?Results?All the patients recovered uneventfully. Operation time was 151.25±42.65 min （ranging　from 90 to 245 min）, cardiopulmonary bypass time was 65.06±29.16 min （ranging from 31 to 116 min）, mean aortic cross-clamping time was 43.00±33.41 min （ranging from 18 to 97 min） and postoperative hospital stay was 12.50±1.45 d　（ranging from 10 to 15 d）. There was no early or late death. All the patients were followed up from 4 months to 6 years and no patient had symptom recurrence, myocardial ischemia or residual fistula during the follow-up.　Conclusions　All CAF patients should be surgically treated once diagnosis are made with satisfactory surgical outcome.

Citation： LU Zirun,CHEN Xin,XU Ming,JIANG Yingshuo,QIU Zhibing,WANG Rui.. Surgical Treatment of Congenital Coronary Artery Fistula. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(6): 597-601. doi: Copy

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2.	Mavroudis C, Dodge-Khatami A, Stewart RD, et al. An overview of surgery options for congenital coronary artery anomalies. Future Cardiol, 2010, 6 （5）：627-645.
3.	Sugiura T, Saito S, Kihara S, et al. Giant coronary artery aneurysm associated with medial mucoid degeneration. Ann Thorac Surg, 2009, 87 （3）：933-934.
4.	Dimitrakakis G, Von Oppell U, Luckraz H, et al. Surgical repair of triple coronary-pulmonary artery fistulae with associated atrial septal defect and aortic valve regurgitation. Interact Cardiovasc Thorac Surg, 2008, 7 （5）：933-934.
5.	El Watidy AM, Ismail HH, Calafiore AM. Surgical management of right coronary artery-coronary sinus fistula causing severe mitral and tricuspid regurgitation. Interact Cardiovasc Thorac Surg, 2010, 10 （1）：110-112.
6.	Said SL, Van der Werf T. Solitary coronary artery fistulas：a congenital anomaly in children and adults. A contemporary review. Congenit Heart Dis, 2006, 1 （3）：63-76.
7.	Guo H, You B, Lee JD. Dilated cardiomyopathy caused by a coronary-pulmonary fistula treated successfully with coil embolization. Circ J, 2006, 70 （9）：1223-1225.
8.	Cooley DA, Ellis PR Jr. Surgical considerations of coronary arterial fistula. Am J Cardiol, 1962, 10 （4）：467-474.
9.	Bothe W, Schlensak C, van de Loo A, et al. A fistula between the circumflex artery and the coronary sinus mimicks coronary artery disease in a 63-year-old woman. Interact Cardiovasc Thorac Surg, 2005, 4 （2）：81-82.
10.	Demirkilic U, Ozal E, Bingol H, et al. Surgical treatment of coronary artery fistulas：15 years’ experience. Asian Cardiovasc Thorac Ann, 2004, 12 （2）：133-138.
11.	Tomasian A, Lell M, Currier J, et al. Coronary artery to pulmonary artery fistulae with multiple aneurysms：radiological features on dual-source 64-slice CT angiography. Br J Radiol, 2008, 81 （969）：e218-e220.
12.	Vavuranakis M, Bush CA, Boudoulas H. Coronary artery fistulas in adults：incidence, angiographic characteristics, natural history. Cathet Cardiovasc Diagn, 1995, 35 （2）：116-120.
13.	Holzer R, Johnson R, Ciotti G, et al. Review of an institutional experience of coronary arterial fistulas in childhood set in context of review of the literature. Cardiol Young, 2004, 14 （4）：380-385.
14.	Muñoz-Guijosa C, Ginel A, Leta R, et al. Giant circumflex coronary artery fistula to the superior vena cava in patient with multiple valvular disease. Ann Thorac Surg, 2008, 86 （3）：e3.
15.	洪李锋, 马业新. 冠状动脉瘘的研究进展. 内科急危重症杂志，2010, 16 （3）：154-156.
16.	Kovacevi? P, Velicki L, Redzek A. Surgical treatment of coronary artery-pulmonary artery fistula with coronary artery disease. J Card Surg, 2009, 24 （6）：670-672.
17.	于伟勇，张宝仁，郝家骅，等. 成人先天性冠状动脉瘘的诊断和外科治疗. 中华外科杂志， 2003， 41 （1）：44-46．.
18.	匡锋，周新民，胡建国，等. 先天性冠状动脉瘘的外科治疗. 中国胸心血管外科临床杂志， 2010， 17 （1）：22-25．.
19.	Inoue H, Ueno M, Yamamoto H, et al. Surgical treatment of coronary artery aneurysm with coronary artery fistula. Ann Thorac Cardiovasc Surg, 2009, 15 （3）：198-202.

1. 　Chiu CZ, Shyu KG, Cheng JJ, et al. Angiographic and clinical manifestations of coronary fistulas in Chinese People：15-year experience. Circ J, 2008, 72 （8）：1242-1248.
2. 　Mavroudis C, Dodge-Khatami A, Stewart RD, et al. An overview of surgery options for congenital coronary artery anomalies. Future Cardiol, 2010, 6 （5）：627-645.
3. 　Sugiura T, Saito S, Kihara S, et al. Giant coronary artery aneurysm associated with medial mucoid degeneration. Ann Thorac Surg, 2009, 87 （3）：933-934.
4. 　Dimitrakakis G, Von Oppell U, Luckraz H, et al. Surgical repair of triple coronary-pulmonary artery fistulae with associated atrial septal defect and aortic valve regurgitation. Interact Cardiovasc Thorac Surg, 2008, 7 （5）：933-934.
5. 　El Watidy AM, Ismail HH, Calafiore AM. Surgical management of right coronary artery-coronary sinus fistula causing severe mitral and tricuspid regurgitation. Interact Cardiovasc Thorac Surg, 2010, 10 （1）：110-112.
6. 　Said SL, Van der Werf T. Solitary coronary artery fistulas：a congenital anomaly in children and adults. A contemporary review. Congenit Heart Dis, 2006, 1 （3）：63-76.
7. 　Guo H, You B, Lee JD. Dilated cardiomyopathy caused by a coronary-pulmonary fistula treated successfully with coil embolization. Circ J, 2006, 70 （9）：1223-1225.
8. 　Cooley DA, Ellis PR Jr. Surgical considerations of coronary arterial fistula. Am J Cardiol, 1962, 10 （4）：467-474.
9. 　Bothe W, Schlensak C, van de Loo A, et al. A fistula between the circumflex artery and the coronary sinus mimicks coronary artery disease in a 63-year-old woman. Interact Cardiovasc Thorac Surg, 2005, 4 （2）：81-82.
10. 　Demirkilic U, Ozal E, Bingol H, et al. Surgical treatment of coronary artery fistulas：15 years’ experience. Asian Cardiovasc Thorac Ann, 2004, 12 （2）：133-138.
11. 　Tomasian A, Lell M, Currier J, et al. Coronary artery to pulmonary artery fistulae with multiple aneurysms：radiological features on dual-source 64-slice CT angiography. Br J Radiol, 2008, 81 （969）：e218-e220.
12. 　Vavuranakis M, Bush CA, Boudoulas H. Coronary artery fistulas in adults：incidence, angiographic characteristics, natural history. Cathet Cardiovasc Diagn, 1995, 35 （2）：116-120.
13. 　Holzer R, Johnson R, Ciotti G, et al. Review of an institutional experience of coronary arterial fistulas in childhood set in context of review of the literature. Cardiol Young, 2004, 14 （4）：380-385.
14. 　Muñoz-Guijosa C, Ginel A, Leta R, et al. Giant circumflex coronary artery fistula to the superior vena cava in patient with multiple valvular disease. Ann Thorac Surg, 2008, 86 （3）：e3.
15. 　洪李锋, 马业新. 冠状动脉瘘的研究进展. 内科急危重症杂志，2010, 16 （3）：154-156.
16. 　Kovacevi? P, Velicki L, Redzek A. Surgical treatment of coronary artery-pulmonary artery fistula with coronary artery disease. J Card Surg, 2009, 24 （6）：670-672.
17. 　于伟勇，张宝仁，郝家骅，等. 成人先天性冠状动脉瘘的诊断和外科治疗. 中华外科杂志， 2003， 41 （1）：44-46．.
18. 　匡锋，周新民，胡建国，等. 先天性冠状动脉瘘的外科治疗. 中国胸心血管外科临床杂志， 2010， 17 （1）：22-25．.
19. 　Inoue H, Ueno M, Yamamoto H, et al. Surgical treatment of coronary artery aneurysm with coronary artery fistula. Ann Thorac Cardiovasc Surg, 2009, 15 （3）：198-202.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Treatment of Congenital Coronary Artery Fistula

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