Journal of Clinical Pediatrics >

2022 , Vol. 40 >Issue 11: 843 - 847

DOI: https://doi.org/10.12372/jcp.2022.21e1291

General Report

Transcatheter closure and short- and medium-term follow-up of 46 children with congenital coronary artery fistula

  • Yue LIU ,
  • Diqi ZHU ,
  • Fen LI ,
  • Lijun FU ,
  • Tingliang LIU ,
  • Ying GUO ,
  • Wei GAO ,
  • Meirong HUANG ,
  • Jie SHEN
Expand
  • Department of Cardiology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

Received date: 2021-09-06

  Online published: 2022-11-10

Fold

Abstract

Objective To analyze the efficacy,complications and prognosis of transcatheter closure (TCC) of congenital coronary artery fistula (CAF) in children. Methods Clinical data of patients diagnosed with CAF and underwent TCC from January 2013 to January 2021 were retrospectively analyzed. Results A total of 46 patients with CAF were enrolled in the study, including 22 boys and 24 girls, with median age of 36.0 (24.5-49.5) months and median body weight of 14.9 (12.2-20.0) kg. In 46 patients with CAF, the fistula shunt was3.4 (3.0-4.4) mm, and there were varying degrees of widening of the involved coronary artery with an internal diameter of 6.1 (4.5-7.8) mm at the opening. It was considered difficult to perform TCC in the other 9 patients. Among the 35 patients who underwent successful TCC, arteriovenous loop was established to perform retrograde closure in 15 patients. The other 20 patients underwent antegrade closure through the aorta. PDA device (8 cases), VSD device (2 cases), coil (3 cases) and vascular plug (22 cases) were used in these patients.Among the 35patients who underwent successful TCC, 10 patients showed immediate residual shunt after closure. Tiny residual shunt disappeared during follow-up in eight patients. Two patients still showed residual shunt at the last follow-up. Thrombosis formation was found in two cases. Conclusion TCC is a safe and effective method for the treatment of CAF in children. It is necessary to fully evaluate the course, opening and collateral vessels of CAF to improve the success of intervention. For patients suffering risk of thrombosis, a longer course of routine anticoagulation after TCC may be required.

Key words： coronary artery fistula; transcatheter closure; residual shunt; thrombosis formation; child

Cite this article

Yue LIU , Diqi ZHU , Fen LI , Lijun FU , Tingliang LIU , Ying GUO , Wei GAO , Meirong HUANG , Jie SHEN . Transcatheter closure and short- and medium-term follow-up of 46 children with congenital coronary artery fistula[J]. Journal of Clinical Pediatrics, 2022 , 40(11) : 843 -847 . DOI: 10.12372/jcp.2022.21e1291

References

[1] Collins N, Mehta R, Benson L, et al. Percutaneous coronary artery fistula closure in adults: technical and procedural aspects[J]. Catheter Cardiovasc Interv, 2007, 69(6): 872‐880.
[2] Ilkay E, Celebi OO, Kacmaz F, et al. Percutaneous closure of coronary artery fistula: long-term follow-up results[J]. Postepy Kardiol Interwencyjnej, 2015, 11(4): 318‐322.
[3] Wang C, Zhou K, Li Y, et al. Percutaneous transcatheter closure of congenital coronary artery fistulae with patent ductus arteriosus occluder in children: focus on patient selection and intermediate-term follow-up results[J]. J Invasive Cardiol, 2014, 26(7): 339‐346.
[4] Gowda ST, Latson LA, Kutty S, et al. Intermediate to long-term outcome following congenital coronary artery fistulae closure with focus on thrombus formation[J]. Am J Cardiol, 2011, 107(2): 302‐308.
[5] Budnur SC, Singh B, Jayaranganath M. Percutaneous transcatheter device closure of coronary arteriovenous fistula through persistent left superior vena cava[J]. J Invasive Cardiol, 2013, 25(2): E24‐E26.
[6] Ghaffari S, Akbarzadeh F, Pourafkari L. Aneurysmal coronary arteriovenous fistula closing with covered stent deployment: a case report and review of literature[J]. Cardiol J, 2011, 18(5): 556‐559.
[7] Lee ML, Chen M. Diagnosis and management of congenital coronary arteriovenous fistula in the pediatric patients presenting congestive heart failure and myocardial ischemia[J]. Yonsei Med J, 2009, 50(1): 95‐104.
[8] Buccheri D, Chirco PR, Geraci S, et al. Coronary Artery Fistulae: Anatomy, Diagnosis and Management Strategies[J]. Heart Lung Circ, 2018, 27(8): 940-951.
[9] Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons[J]. J Am Coll Cardiol, 2008, 52(23): e143-e263.
[10] Armsby LR, Keane JF, Sherwood MC, et al. Management of coronary artery fistulae. Patient selection and results of transcatheter closure[J]. J Am Coll Cardiol, 2002, 39(6): 1026‐1032.
[11] Qureshi SA, Tynan M. Catheter closure of coronary artery fistulas[J]. J Interv Cardiol, 2001, 14(3): 299‐307.
[12] Liu X, Zhang L, Qi Z, et al. The characteristics of coronary-pulmonary artery fistulas and the effectivity of trans-catheter closure: a single center experience[J]. J Thorac Dis, 2019, 11(7): 2808‐2815.
[13] Mavroudis C, Backer CL, Rocchini AP, et al. Coronary artery fistulas in infants and children: a surgical review and discussion of coil embolization[J]. Ann Thorac Surg, 1997, 63(5): 1235‐1242.
[14] Latson LA. Coronary artery fistulas: how to manage them[J]. Catheter Cardiovasc Interv, 2007, 70(1): 110‐116.
[15] Zhu XY, Zhang DZ, Han XM, et al. Transcatheter closure of congenital coronary artery fistulae: immediate and long-term follow-up results[J]. Clin Cardiol, 2009, 32(9): 506‐512.
[16] Jama A, Barsoum M, Bjarnason H, et al. Percutaneous closure of congenital coronary artery fistulae: results and angiographic follow-up[J]. JACC Cardiovasc Interv, 2011, 4(7): 814‐821.
[17] Xiao Y, Gowda ST, Chen Z, et al. Transcatheter closure of coronary artery fistulae: considerations and approaches based on fistula origin[J]. J Interv Cardiol, 2015, 28(4):380-389.
[18] Collins N, Benson LN, Horlick EM. Iatrogenic ST elevation during percutaneous closure of a coronary artery fistula[J]. Congenit Heart Dis, 2012, 7(1): 80‐83.
[19] Kharouf R, Cao QL, Hijazi ZM. Transcatheter closure of coronary artery fistula complicated by myocardial infarction[J]. J Invasive Cardiol, 2007, 19(5): E146‐E149.
[20] Ascoop AK, Budts W. Percutaneous closure of a congenital coronary artery fistula complicated by an acute myocardial infarction[J]. Acta Cardiol, 2004, 59(1): 67‐69.
[21] Thakkar B, Patel N, Poptani V, et al. Clinical and angiographic follow-up of coronary artery fistula interventions in children: techniques and classification revisited[J]. Cardiol Young, 2015, 25(4): 670‐680.
[22] El-Sabawi B, Al-Hijji MA, Eleid MF, et al. Transcatheter closure of coronary artery fistula: a 21-year experience[J]. Catheter Cardiovasc Interv, 2020, 96(2): 311-319.
[23] Newburger JW. Kawasaki disease: medical therapies[J]. Congenit Heart Dis, 2017, 12(5): 641-643.
Options
Outlines

/

〈 〉

Website Copyright © 2018 Journal of Clinical Pediatrics.
Tel: 021-25076489　E-mail: jcperke@126.com
Powered by Beijing Magtech Co. Ltd