Acquired and progressive coronary arterial fistulae in patients with single-ventricle physiology and treated with pulmonary vasodilators
Autor: | Shintaro Nemoto, Hayato Konishi, Hiroshi Katayama, Akira Ashida, Noriyasu Ozaki, Atsuko Ashida, Kanta Kishi, Yutaka Odanaka |
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Rok vydání: | 2021 |
Předmět: |
Heart Defects
Congenital medicine.medical_specialty Heart Ventricles Vasodilator Agents 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans In patient Adverse effect Retrospective Studies business.industry General Medicine medicine.disease medicine.anatomical_structure Treatment Outcome Bypass surgery Ventricle Single ventricle physiology Pulmonary Atresia 030220 oncology & carcinogenesis Heart failure Pediatrics Perinatology and Child Health Cardiology Cardiology and Cardiovascular Medicine Hepatic fibrosis business Pulmonary vasodilators |
Zdroj: | Cardiology in the young. 31(11) |
ISSN: | 1467-1107 1047-9511 |
Popis: | Background:Cardiac dysfunction, arrhythmia, and hepatic fibrosis are well-known complications after right heart bypass surgery in patients with single-ventricle physiology. However, little is known about coronary arterial fistulae, and only a few reports have been published. This study aimed to elucidate the clinical characteristics of these rare coronary arterial fistulae that developed as complications in cases of single-ventricle physiology after right heart bypass surgery.Methods:We retrospectively investigated the clinical features and courses of patients who developed acquired and progressive coronary arterial fistulae after right heart bypass surgery in our hospital.Results:We identified three cases of coronary arterial fistulae out of 21 patients who underwent right heart bypass surgery. All three cases underwent cardiac catheterisation for post-operative evaluation and were administered pulmonary vasodilators of phosphodiesterase type V inhibitors, antiplatelet, anticoagulation, and diuretics. Moreover, they had common clinical features such as right-dominant single ventricle and long-term exposure to chronic hypoxia. Serial angiograms revealed acquired and progressive coronary arterial fistulae. In addition, coronary arterial fistulae contributed to their symptoms of heart failure.Conclusion:Patients with chronic hypoxia and dominant right ventricle, who are treated with phosphodiesterase type V inhibitors, should be followed up after right heart bypass surgery to monitor the possible development of coronary arterial fistulae. Moreover, the indication for pulmonary vasodilators in single-ventricle physiology after right heart bypass surgery should be optimised to avoid adverse effects. |
Databáze: | OpenAIRE |
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