Open Access

ARTICLE

The clinical characteristics of coronary artery fistula anomalies in children and adults: A 24‐year experience

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1 Department of Cardiology, Tam Duc Heart Hospital, Ho Chi Minh City, Vietnam
2 Department of Cardiology, The Sue and Bill Butler Research Fellow, The Linder Research Center, Cincinnati, Ohio, USA
3 Department of Cardiology, The Christ Hospital Health Network and The Lindner Research Center, Cincinnati, Ohio, USA
4 Department of Cardiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
5 Department of Cardiology, Tan Tao University School of Medicine, Tan Duc Ecity, Long An, Vietnam
6 Department of Cardiology, The Margo and Frank Homan Family Foundation Endowed Chair in Heart Failure
7 Department of Cardiology, Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
8 Department of Cardiology, Heart Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam

* Corresponding Author: Kieu T. Huynh, Tam Duc Heart Hospital, 4 Nguyen Luong Bang, District 7, Ho Chi Minh City, Vietnam. Email:

Congenital Heart Disease 2019, 14(5), 772-777. https://doi.org/10.1111/chd.12781

Abstract

Objectives: The aim of our work is to investigate the clinical characteristics of coro‐ nary artery fistula (CAF) anomalies in South Vietnam.
Methods: This is a retrospective analysis of 119 patients with diagnosis of definite CAF between January 1992 and April 2016. The demographic, clinical, echocardio‐ graphic, and angiographic characteristics and management of CAF with short‐term outcomes are described.
Results: The median age was 15 years (range, 1‐79 years), with 49 male (41%) and 70 female (59%). There were 77 symptomatic patients (64.7%) and 91 patients (76.5%) who presented with a murmur. The electrocardiogram was abnormal in 45.4% and cardiac enlargement or increased pulmonary vasculature were seen in 76 patients (63.9%) on chest X‐ray. The sensitivity of echocardiography for CAF diagnosis was 79%. The source of the fistula was most often from the RCA (54%), most commonly to right atrium (34.5%) or right ventricle (31.1%). In comparison with surgery, tran‐ scatheter closure had a shorter hospital length of stay (5.4 ± 3.8 days vs 12.6 ± 6.5 days, P = .02) and better postprocedural left ventricular ejection fraction (67.9 ± 8.1% vs 62.9 ± 6.0%, P = .03).
Conclusion: The majority of fistula in this study originated from the RCA and termi‐ nated in the right atrium or the right ventricle. Transcatheter and surgical closure are both relatively safe and effective, with the potential for shortened length of hospital stay following transcatheter closure.

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