Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

摘要: AIM: To describe the characteristics of coronary artery fistulas (CAFs) in adults, including donor vessels and whether termination was cameral or vascular. METHODS: A PubMed search performed for articles between 2000 2010 to current congenital CAFs adults. group 304 adults collected. Clinical data, presentations, diagnostic modalities, angiographic fistula findings treatment strategies were gathered analyzed. With regard CAF origin, subjects tabulated into unilateral, bilateral multilateral compared. The stratified two major subsets according mode termination; coronary-cameral (CCFs) coronary-vascular (CVFs). comparison made subsets. Fistula-related complications [aneurysm formation, infective endocarditis (IE), myocardial infarction (MI), rupture, pericardial effusion (PE) tamponade] described. Coronary artery-ventricular multiple micro-fistulas acquired excluded as well anomalous origin arteries from pulmonary (PA). RESULTS: total adult (47% male) with included. mean age 51.4 years (range, 18-86 years), 20% older than 65 age. Dyspnea (31%), chest pain (23%) angina pectoris (21%) prevalent clinical presentations. Continuous cardiac murmur heard 82% subjects. Of applied X-ray showed an abnormal shadow 4% cornerstone establishing diagnosis echocardiography (68%), conventional contrast angiography (97%). However, multi-slice detector computed tomography 16%. unilateral originated left 69% right 31% Most patients (80%) had fistulas, 18% presented 2% fistulas. Termination PA reported (44%), (73%) (75%) Fistulas origins (bilateral multilateral) terminated more frequently (29%) other sites (10.6%) (P = 0.000). Aneurysmal formation found 14% all Spontaneous PE tamponade In CCFs, 46.2 whereas CVFs 55.6 0.003). IE (4%) exclusively associated while MI (2%) only CVFs. Surgical ligation chosen (57%), (51%) (66%), but percutaneous therapeutic embolization (PTE) increasingly (23%, 17% 17%, respectively). CONCLUSION: Congenital are currently detected elderly patients. Bilateral PTE is a strategy