Two Cases of Surgical Repair of Coronary Artery Fistulas in Children

VernacularTitle:小児冠動脈瘻の2手術例
Author: Takashi Igarashi ; Hitoshi Yokoyama ; Hirono Satokawa ; Hiroki Wakamatsu
Publication Type:Journal Article
Keywords: coronary artery fistula; coronary artery bypass grafting
From:Japanese Journal of Cardiovascular Surgery 2010;39(1):21-24
CountryJapan
Language:Japanese
Abstract: We report two cases of coronary artery fistulas (CAF) in children with successful surgical repair. The first case was a 14-year-old boy with a continuous heart murmur. A fistula was diagnosed between the right coronary artery (RCA) and the right atrium by echocardiography. He was asymptomatic, but the pulmonary to systemic flow ratio was shown to be high by cardiac catheterization. He underwent surgical closure of the fistula and coronary artery bypass grafting to the RCA with the right interthoracic artery. The second case was a 5-year-old boy with a continuous heart murmur and cardiomegaly on the chest X-ray film. The CAF from the left coronary artery to the right atrium was revealed by echocardiography. The pulmonary to systemic flow ratio was shown to be high by cardiac catheterization. He was asymptomatic, but he also underwent surgical closure of CAF. Surgical repair was effective and safe in these cases. Echocardiography was very useful in the diagonosis of CAF. Surgical repair in the young is recommended because CAF is much more likely to cause congestive heart failure, angina, and infective endocarditis when growing.