Objective To probe into the safety and effectiveness of transcatheter interventional therapy of congenital coronary artery fistula.
Methods From May 2004 to December 2013 there were 63 patients of congenital coronary artery fistula with an average age of 59.7 ± 15.8 years (26 to 85 years), including 39 male and 24 female, who received transcatheter interventional therapy. Closure devices, such as coils, vascular closure devices and patent ductus arteriosus occlusion, were send to fistula through the microcatheter along coronary guiding catheter or through a delivery sheath after establishing track.
Results Angiography showed CAF was single in 41 cases (65.1%) and multiple in 22 cases (34.9%). 58 cases of patients occluded successfully with technical success rate of 92.1% (58/63). 7 cases used patent ductus arteriosus occluder, 5 cases used Plug, and 48 cases used Guglielmi detachable coils. Immediate postoperative angiography showed there was no residual shunt or only a small amount of residual shunt. After operation there happened 1 case of transient hemolysis, 3 cases of transient mild elevation of troponin, but no death. Patients were followed up from 3 to 15 months with symptoms gradually easing and heart function improving. Six months Six months after occlusion 15 patients underwent coronary CTA or coronary angiography, which showed there were no residual fistula.
Conclusions We believe that transcatheter interventional therapy of congenital coronary artery fistula is a microtrauma, safe, and effective procedure, which could be first-select for this disease.
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