Clinical analysis of congenital coronary artery fistula in 71 children
10.3760/cma.j.cn101070-20200823-01400
- VernacularTitle:儿童先天性冠状动脉瘘71例临床分析
- Author:
Yue LIU
1
;
Fen LI
;
Lijun FU
;
Tingliang LIU
;
Ying GUO
;
Wei GAO
;
Meirong HUANG
;
Hao ZHANG
;
Jie SHEN
Author Information
1. 上海交通大学医学院附属上海儿童医学中心心血管内科，上海 200127
- Keywords:
Child;
Congenital coronary artery fistula;
Percutaneous closure;
Operation;
Thrombosis
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(2):94-97
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics, therapeutic efficacy and prognosis of congenital coronary artery fistula (CAF) in children.Methods:Clinical data of 71 pediatric patients diagnosed with congenital CAF at Department of Cardiology and Department of Cardiac Surgery, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine from January 2013 to June 2019 were retrospectively analyzed.The median age was 2.2 years (0.1-14.0 years), and the median body weight was 18.3 kg (3.2-55.8 kg), including 37 males (52.1%) and 34 females (47.9%). They were divided into the transcatheter closure group (30 cases) and surgical repair group (41 cases). The therapeutic effect and follow-up data of the 2 groups were compared by the Fisher′ s exact test. Results:Among the 71 congenital CAF children, 70 had heart murmurs, 2 had chest tightness after activity, and 5 were prone to recurrent respiratory tract infection.Transcatheter closure and surgical repair were successfully performed in 22/30 (73.3%) and 41/41 (100.0%) cases with a statistically significant difference ( P=0.001). However, in the surgical repair group, 1 (2.4%) case died after operation and 2(4.9%) needed further transcatheter closure due to large residual shunt during the follow-up period.At the last follow-up, there were 2 cases with minimal or small residual shunt in both groups ( P=0.567). There were 2/71(2.8%) cases suffering from postoperative thrombosis. Conclusions:Cardiac murmur is the main sign of congenital CAF in children, and some of them may have frequent respiratory tract infection due to increased lung blood caused by a large amount of shunt.A few children have chest tightness and chest pain due to myocardial ischemia caused by coronary steal.Both percutaneous closure and surgical repair are safe and effective with few complications.
