Prevalence and characteristics of patients with solitary coronary artery fistulas in 12,757 all comer adult patients undergoing coronary angiography (RCD code: I 1C.4)

Abstract

Introduction Coronary artery fistula (CAF) is a rare anomaly, mostly congenital, defined as an abnormal direct connection between one of the coronary arteries and a heart chamber or major vessel. In case of coronary steal, CAF may manifest with symptoms of stable coro‐ nary disease (CAD). Methods We investigated medical records of all adult patients who underwent coronary angiography (CAG) from 1 July 2009 to 30 June 2019. Patients with solitary CAF were selected. Coronary artery‐ventricular multiple microfistulas (MMFs) were recorded but were no object for further analysis. The CAFs were grouped depending on the origin and termination. Clinical symptoms, comorbidities and past medical history were analyzed. Results 26 solitary CAFs were found in 22 (0.17%) and 20 MMFs in 16 (0.13%) out of 12,757 patients who underwent CAG for any reason in that period. Indication for CAG varied among study group. Left coronary artery (LCA) gave origin to majority (57.69%) of fistulas. Pulmonary artery (PA) was the most common drainage site (69.23%). 17 patients had HA, 15 suffered from chest pain or dyspnoea, 13 had dyslipidemia, and half had CAD. Conclusion The incidence of solitary CAF in the sample of all‐comer population of Polish patients undergoing CAG was 0.17%. LCA was the most common artery of origin and PA was the most frequent drainage site. The indication for CAG varied among patients. Majority of patients suffered from chest pain or dyspnea, had HA, dyslipidemia, and half had CAD. Moreover, the incidence of MMF was 0.13%. JRCD 2019; 4 (3): 42-46.