Percutaneous closure of congenital isolated coronary cameral fistulae: Case series with angiographic profile and immediate and intermediate follow up

Abstract

BackgroundCoronary artery fistulae are very rare congenital anomalies constituting 0.2–0.4% of all congenital heart diseases. The most common sites of communication of fistulae are the right cardiac chambers. Large fistulae may cause hemodynamic impairment in the coronary circulation. MethodsWe are presenting a case series of seven patients of which six underwent successful percutaneous closure of a coronary cameral fistula along with their clinical presentation and their immediate outcome and intermediate term follow up. ResultsThree of the cases had fistula originating from the right coronary artery, 2 of which were draining in to the right atrium and 1 draining in to left ventricle. Other three of the cases had fistula originating from the left circumflex coronary artery draining into coronary sinus in one case and right atrium in two cases while one patient each had fistula originating from the left anterior descending artery draining into left ventricle.Three were closed with Amplatzer vascular plug, one with Lifetech patent ductus arteriosus occluder device, one each with Amplatzer duct occluder I and -II device. One patient did not consent for the intervention. No complication was seen during the procedure or during the follow up. All the patients were asymptomatic in recent follow up after 1–2 years. ConclusionThis series gives evidence that percutaneous closure of coronary cameral fistula of varying sizes is a safe and effective alternative for surgery and the successful results are maintained during the course of follow up and thereby should be preferred as the first alternative.