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Coronary arterial fistulas in childhood

Published online by Cambridge University Press:  19 August 2008

Kin-tak Wong  and
Samuel Menahem
Kin-tak Wong
Affiliation:
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
Samuel Menahem*
Affiliation:
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
*
Prof. S. Menahem, Department of Cardiology, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia. Tel: 61 3 9345–5712; Fax: 61 3 9345–6001
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Abstract

We reviewed 16 patients with coronary arterial fistulas seen between 1976 and 1997, and aged 2 days to 16 years, with a median age of 3.2 years. Only four patients were symptomatic: two had heart failure, one had exertional dyspnoea, and one infective endocarditis. The fistulas originated from the right coronary artery in seven patients, from the left coronary artery in seven, from both coronary arteries in one patient, while the origin was not clearly defined in the final patient. Associated cardiac anomalies were discovered in six patients, with three of the fistulas being diagnosed at the same presentation. Cross-sectional echocardiography had revealed a dilated coronary artery in 7 out of 11 subjects. The ratio of pulmonary to systemic flows ranged between 0.9 to 3.0, with a median of 1.5. Ten patients were referred for corrective surgery without any mortality. Trans-catheter closure was successfully undertaken in one patient, while spontaneous closure of the fistula was noted in two patients. We conclude that coronary arterial fistulas, although rare and potentially serious, are generally treatable.

Keywords

congenital malformationsechocardiographycatheteroutcome
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 1 , January 2000 , pp. 15 - 20
Copyright
Copyright © Cambridge University Press 2000

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