Diagnostic and therapeutic approach of congenital solitary coronary artery fistulas in adults
| Autor: | D. Gerrits, A. C. B. Pronk, K.G. van Houwelingen, U. Sonker, Salah A.M. Saïd, D. M. Nicastia, A. C. Tans, G. P. Kimman, E. M. Koomen, Rogier Lg Nijhuis, N. Y. Y. Al-Windy, A. B. Huisman, Riemer H. J. A. Slart, J. W. op den Akker, T. Slagboom |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
Positron emission tomography Percutaneous Fistula medicine.medical_treatment Coronary angiography COLOR DOPPLER-ECHOCARDIOGRAPHY SUPERIOR VENA-CAVA Arteriovenous fistula VENTRICULAR FISTULA Review Coronary artery fistula Multidetector computed tomography TRANSESOPHAGEAL ECHOCARDIOGRAPHY PULMONARY-ARTERY medicine.artery Percutaneous occlusion MAGNETIC-RESONANCE medicine COMPUTED-TOMOGRAPHY Surgical ligation medicine.diagnostic_test business.industry ARTERIOVENOUS-FISTULA Magnetic resonance imaging medicine.disease Surgery MYOCARDIAL-PERFUSION RESERVE medicine.anatomical_structure Right coronary artery SURGICAL-TREATMENT Pulmonary artery Radiology Cardiology and Cardiovascular Medicine business Watchful waiting Artery |
| Zdroj: | Netherlands Heart Journal. 19(4):183-191 |
| ISSN: | 1568-5888 |
| Popis: | Background Coronary artery fistulas (CAFs) are infrequent anomalies, coincidentally detected during coronary angiography (CAG). Aim To elucidate the currently used diagnostic imaging modalities and applied therapeutic approaches. Materials and Methods Five Dutch patients were found to have CAFs. A total of 170 reviewed subjects were subdivided into two comparable groups of 85 each, treated with either percutaneous 'therapeutic' embolisation (PTE group) or surgical ligation (SL group). Results In our series, the fistulas were visualised with several diagnostic imaging tests using echocardiography, multidetector computed tomography, and CAG. Four fistulas were unilateral and one was bilateral; five originated from the left and one originated from the right coronary artery. Among the reviewed subjects, high success rates were found in both treatment groups (SL: 97% and PTE: 93%). Associated congenital or acquired cardiovascular disorders were frequently present in the SL group (23%). Bilateral fistulas were present in 11% of the SL group versus 1% of the PTE group. The fistula was ligated surgically in one and abolished percutaneously in another. Medical treatment including metoprolol was conducted in two, and watchful waiting follow-up was performed in one. Conclusions Several diagnostic imaging techniques are available for assessment of the anatomical and functional characteristics of CAFs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|