Prevalence and characteristics of patients with solitary coronary artery fistulas in 12,757 all‐comer adult patients undergoing coronary angiography (RCD code: I‐1C.4)

Jakub Chmiel, Miłosz K. Książek, Grażyna Świtacz, Jagoda Dradrach, Paweł Iwaszczuk, Leszek Drabik, Piotr Podolec, Piotr Musiałek

Full Text:

PDF PDF

Abstract


Introduction Coronary artery fistula (CAF) is a rare anomaly, mostly congenital, defined as an abnormal direct connection between one of the coronary arteries and a heart chamber or major vessel. In case of coronary steal, CAF may manifest with symptoms of stable coro‐
nary disease (CAD). Methods We investigated medical records of all adult patients who underwent coronary angiography (CAG) from 1 July 2009 to 30 June 2019. Patients with solitary CAF were selected. Coronary artery‐ventricular multiple microfistulas (MMFs) were
recorded but were no object for further analysis. The CAFs were grouped depending on the origin and termination. Clinical symptoms, comorbidities and past medical history were analyzed. Results 26 solitary CAFs were found in 22 (0.17%) and 20 MMFs in 16 (0.13%)
out of 12,757 patients who underwent CAG for any reason in that period. Indication for CAG varied among study group. Left coronary artery (LCA) gave origin to majority (57.69%) of fistulas. Pulmonary artery (PA) was the most common drainage site (69.23%). 17 patients
had HA, 15 suffered from chest pain or dyspnoea, 13 had dyslipidemia, and half had CAD. Conclusion The incidence of solitary CAF in the sample of all‐comer population of Polish patients undergoing CAG was 0.17%. LCA was the most common artery of origin and PA was
the most frequent drainage site. The indication for CAG varied among patients. Majority of patients suffered from chest pain or dyspnea, had HA, dyslipidemia, and half had CAD. Moreover, the incidence of MMF was 0.13%. JRCD 2019; 4 (3): 42-46.


Keywords


coronary artery fistula; coronary artery anomaly; rare cardiovascular disease; coronary angiography

References


Luo L, Kebede S, Wu S, et al. Coronary Artery Fistulae. Am J Med Sci 2006; 332: 79–84.

Said SA, van der Werf T. Dutch survey of coronary artery fistulas in adults: congenital solitary fistulas. Int J Cardiol 2006; 106: 323–332

Raju MG, Goyal SK, Punnam SR, et al. Coronary artery fistula: a case series with review of the literature. J Cardiol 2009; 53: 467–472.

Mangukia CV. Coronary artery fistula. Ann Thorac Surg. 2012; 93(6): 2084–2092.

Sandhu JS, Uretsky BF, Zerbe TR, et al. Coronary artery fistula in the heart transplant patient: a potential complication of endomyocardial biopsy. Circulation 1989; 79: 50–356.

Gasser S, Gasser R, Bareza N, et al. Iatrogenic coronary fistula in post transplant patients: Pathogenesis, Clinical Features and Therapy. J Clin Bas Cardiol 2003; 6: 19–21.

Hobbs RE, Millit HD, Raghavan PV, et al. Coronary artery fistulae: a 10‐year review. Cleve Clin J 1982; 49: 191–7.

Gillebert C, van Hoof R, Van der Werf F, et al. Coronary artery fistulas in an adult population. Eur Heart J 1986; 7: 437–43.

Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990; 21: 28–40.

Vavuranakis M, Bush CA, Boudoulas H. Coronary artery fistulas in adults: incidence, angiographic characteristics, natural history. Cathet Cardiovasc Diagn 1995; 35: 116–20

Yildiz A, Okcun B, Peker T, et al. Prevalence of coronary artery anomalies in 12,457 adult patients who underwent coronary angiography. Clin Cardiol. 2010; 33(12): E60–E64.

Lim JJ, Jung JI, Lee BY, et al. Prevalence and types of coronary artery fistulas detected with coronary CT angiography. AJR Am J Roentgenol. 2014;203(3): W237–W243

Fernandes ED, Kadivar H, Hallman GL, et al. Congenital malformations of the coronary arteries: the Texas Heart Institute experience. Ann Thorac Surgery 1992; 54: 732.

Loukas M, Germain AS, Gabriel A, et al. Coronary artery fistula: a review. Cardiovasc Pathol 2015; 24: 141–8.




DOI: http://dx.doi.org/10.20418%2Fjrcd.vol4no3.384

Refbacks

  • There are currently no refbacks.
Journal of Rare Cardiovascular Diseases (JRCD)
John Paul II Hospital in Kraków, 80 Prądnicka Str., 31-202 Kraków, Poland
Phone: +48 (12) 614 33 99, +48 (12) 614 34 88 Fax: +48 (12) 614 34 88
e-mail: rarediseases@szpitaljp2.krakow.pl
Published by SoftQ sp. z o.o.
ul. Oleandry 2, 30-063 Kraków, Poland
Phone: +48 (12) 444 1650 Fax: +48 (12) 444 1659
e-mail: softq@softq.pl