Coronary Artery Fistulae: Anatomy, Diagnosis and Management Strategies.

摘要: Coronary artery fistula (CAF) is a relatively rare anatomic abnormality of the coronary arteries that afflicts 0.002% general population and represents 14% all anomalies arteries. Its clinical relevance focusses mainly on mechanism "coronary steal phenomenon", causing myocardial functional ischaemia even in absence stenosis, hence common symptoms are angina or effort dyspnoea. The suggested diagnostic approach guided by patient's consists number instrumental examinations like ECG, treadmill test, echocardiography, computed tomography scan, cardiac magnetic resonance angiography. If it not an incidental finding, angiography required view optimal therapeutic planning. Small-sized fistulae usually asymptomatic have excellent prognosis if managed medically with follow-up echocardiography every 2 to 5 years. In case symptomatic, large-sized giant invasive treatment, transcatheter surgical ligation, reasonable choice, both strategies show equivalent results at long-term follow-up. Antibiotic prophylaxis for prevention bacterial endocarditis recommended patients who undergo dental, gastrointestinal urological procedures. A life-long always essential ensure patient undergoing progression disease further complications.