Long-term outcome of interventional approaches for treatment of coronary artery fistulas: a retrospective cohort study in a great referral center.
Coronary artery fistulas
Interventional approaches
Patients
Journal
The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
ISSN: 2090-911X
Titre abrégé: Egypt Heart J
Pays: Germany
ID NLM: 9106952
Informations de publication
Date de publication:
27 Mar 2023
27 Mar 2023
Historique:
received:
01
07
2022
accepted:
17
02
2023
medline:
28
3
2023
entrez:
27
3
2023
pubmed:
28
3
2023
Statut:
epublish
Résumé
Despite the spontaneous regression of many cases of coronary artery fistulas (CAFs), symptomatic patients or cases with severe shunting may require therapeutic interventions. In the present study, we aimed to assess the outcome of treatment of CAFs using interventional approaches. This retrospective cohort study was performed on 29 patients with CAFs that were referred to our tertiary center between 2009 and 2019. Baseline characteristics were collected by reviewing the hospital files, and the patients were followed up to assess long-term outcomes with a mean follow-up of 3.3 years. Overall, in 29 patients in our cohort study, 82.9% suffered from isolated CAFs and in the remaining cases, concurrent congenital abnormalities did exist. For treatment, coils (Cook, Pfm, Ev3) were used in 79.3%, ADO II(AGA) in 18.3%, vascular plug (AGA) in 3.4%, and a combination of coil/ vascular plug/amplatzer in 3.4%. Postoperative complications were reported in 4 patients as external iliac artery thrombosis, transient PSVT, ST-T wave changes and mild pericardial effusion that were all managed successfully with no adverse sequels. No coronary artery injury, device dislocation, dissection, ischemia or coronary dilatation occurred, and there was no death. As larger fistulas were treated by a retrograde approach through the right side of the heart, there was significant correlation between residual shunts and the mode of closure approach; the majority of the residual shunts occurred in patients in the retrograde approach group. Trans-catheter approach for treating CAFs leads to appropriate long-term outcome with minimal potential side effects.
Sections du résumé
BACKGROUND
BACKGROUND
Despite the spontaneous regression of many cases of coronary artery fistulas (CAFs), symptomatic patients or cases with severe shunting may require therapeutic interventions. In the present study, we aimed to assess the outcome of treatment of CAFs using interventional approaches.
METHODS
METHODS
This retrospective cohort study was performed on 29 patients with CAFs that were referred to our tertiary center between 2009 and 2019. Baseline characteristics were collected by reviewing the hospital files, and the patients were followed up to assess long-term outcomes with a mean follow-up of 3.3 years.
RESULTS
RESULTS
Overall, in 29 patients in our cohort study, 82.9% suffered from isolated CAFs and in the remaining cases, concurrent congenital abnormalities did exist. For treatment, coils (Cook, Pfm, Ev3) were used in 79.3%, ADO II(AGA) in 18.3%, vascular plug (AGA) in 3.4%, and a combination of coil/ vascular plug/amplatzer in 3.4%. Postoperative complications were reported in 4 patients as external iliac artery thrombosis, transient PSVT, ST-T wave changes and mild pericardial effusion that were all managed successfully with no adverse sequels. No coronary artery injury, device dislocation, dissection, ischemia or coronary dilatation occurred, and there was no death. As larger fistulas were treated by a retrograde approach through the right side of the heart, there was significant correlation between residual shunts and the mode of closure approach; the majority of the residual shunts occurred in patients in the retrograde approach group.
CONCLUSIONS
CONCLUSIONS
Trans-catheter approach for treating CAFs leads to appropriate long-term outcome with minimal potential side effects.
Identifiants
pubmed: 36971984
doi: 10.1186/s43044-023-00339-4
pii: 10.1186/s43044-023-00339-4
pmc: PMC10043114
doi:
Types de publication
Journal Article
Langues
eng
Pagination
22Informations de copyright
© 2023. The Author(s).
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