Diagnosis and Management of Congenital Coronary Artery Fistulas in Adults.

Autor: Kanduri J; Division of Cardiology, Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, 520 East 70 Street, New York, NY, 10021, USA. jsk9017@nyp.org., Falk Z; Division of Cardiology, Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, 520 East 70 Street, New York, NY, 10021, USA., Singh HS; Division of Cardiology, Department of Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, 520 East 70 Street, New York, NY, 10021, USA.
Jazyk: angličtina
Zdroj: Current cardiology reports [Curr Cardiol Rep] 2024 May; Vol. 26 (5), pp. 373-379. Date of Electronic Publication: 2024 Mar 11.
DOI: 10.1007/s11886-024-02038-1
Abstrakt: Purpose of Review: This review describes the presentation, diagnosis, and management of congenital coronary artery fistulas (CAFs) in adults.
Recent Findings: CAFs are classified as coronary-cameral or coronary arteriovenous fistulas. Fistulous connections at the distal coronary bed are more likely to be aneurysmal with higher risk of thrombosis and myocardial infarction (MI). Medium-to-large or symptomatic CAFs can manifest as ischemia, heart failure, and arrhythmias. CAF closure is recommended when there are attributable symptoms or evidence of adverse coronary remodeling. Closure is usually achievable using transcatheter techniques, though large fistulas may require surgical ligation with bypass. Given their anatomic complexity, cardiac CT with multiplanar 3-D reconstruction can enhance procedural planning of CAF closure. Antiplatelet and anticoagulation are essential therapies in CAF management. CAFs are rare cardiac anomalies with variable presentations and complex anatomy. CAF management strategies include indefinite medical therapy, percutaneous or surgical CAF closure, and lifelong patient surveillance.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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