Hamid Amoozgar1,2, Mohammad Reza Edraki3, Amir Naghshzan4,5,6, Nima Mehdizadegan3,2, Hamid Mohammadi1, Gholamhossein Ajami1, Ahmad Ali Amirghofran7. 1. The Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 2. Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 3. The Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 4. The Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. AmirNaghshzan@gmail.com. 5. Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. AmirNaghshzan@gmail.com. 6. Cardiovascular and Neonatology Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. AmirNaghshzan@gmail.com. 7. Cardiac Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
BACKGROUND: Coronary artery fistula (CAF) is a rare congenital anomaly with a challenging scenario in children. This study reports our experience in transcatheter closure of CAF with Nit-Occlude PDA coil and midterm clinical and imaging follow-up. METHODS: Twelve children with congenital CAF between 2009 and 2019, mean age 2.05 ± 2.05 years (4 days to 7.2 years), mean weight 8.8 ± 4.83 (2.8-17 kg), who underwent transcatheter closure with PFM coil at the Namazi hospital, Shiraz, Iran, were reported. Echocardiography and electrocardiogram were done before and after the procedure (early, 3, and 6 months after), and Multi-slice computerized tomography or conventional coronary angiography was performed at least one year after closure. RESULTS: In a median follow-up of 5.5 years (range 13 months to 8 years), retrogradely closed fistula had no residual, and the fistula tract was wholly occluded, but in most anterogradely closed fistula, had a small residual, which made the fistula tract open and need additional coil closure. CONCLUSIONS: Transcatheter closure of CAF with PFM coil is feasible and effective with low mortality and morbidity, although antegrade closure with this device may be accompanied by residual shunt and need for multiple coil insertion.
BACKGROUND:Coronary artery fistula (CAF) is a rare congenital anomaly with a challenging scenario in children. This study reports our experience in transcatheter closure of CAF with Nit-Occlude PDA coil and midterm clinical and imaging follow-up. METHODS: Twelve children with congenital CAF between 2009 and 2019, mean age 2.05 ± 2.05 years (4 days to 7.2 years), mean weight 8.8 ± 4.83 (2.8-17 kg), who underwent transcatheter closure with PFM coil at the Namazi hospital, Shiraz, Iran, were reported. Echocardiography and electrocardiogram were done before and after the procedure (early, 3, and 6 months after), and Multi-slice computerized tomography or conventional coronary angiography was performed at least one year after closure. RESULTS: In a median follow-up of 5.5 years (range 13 months to 8 years), retrogradely closed fistula had no residual, and the fistula tract was wholly occluded, but in most anterogradely closed fistula, had a small residual, which made the fistula tract open and need additional coil closure. CONCLUSIONS: Transcatheter closure of CAF with PFM coil is feasible and effective with low mortality and morbidity, although antegrade closure with this device may be accompanied by residual shunt and need for multiple coil insertion.
Authors: Carole A Warnes; Roberta G Williams; Thomas M Bashore; John S Child; Heidi M Connolly; Joseph A Dearani; Pedro del Nido; James W Fasules; Thomas P Graham; Ziyad M Hijazi; Sharon A Hunt; Mary Etta King; Michael J Landzberg; Pamela D Miner; Martha J Radford; Edward P Walsh; Gary D Webb Journal: Circulation Date: 2008-11-07 Impact factor: 29.690