Surgical Management of Coronary Artery Fistulas in Children
Background: This study investigated the surgical outcomes associated with coronary artery fistulas (CAFs) in children. Methods: We retrospectively reviewed the medical records of 23 pediatric patients who underwent surgical closure of CAFs between 1995 and 2021. At presentation, 7 patients (30.4...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2024-01-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| Summary: | Background: This study investigated the surgical outcomes associated with coronary
artery fistulas (CAFs) in children.
Methods: We retrospectively reviewed the medical records of 23 pediatric patients who
underwent surgical closure of CAFs between 1995 and 2021. At presentation, 7 patients
(30.4%) exhibited symptoms. Associated cardiac anomalies were present in 8 patients.
Fourteen fistulas originated from the right coronary artery and 9 from the left. The most
common drainage site was the right ventricle, followed by the right atrium and the left
ventricle. The median follow-up duration was 9.3 years (range, 0.1–25.6 years)
Results: The median age and body weight at repair were 3.1 years (range, 0–13.4 years)
and 14.4 kg (range, 3.1–42.2 kg), respectively. Cardiopulmonary bypass was used in 17
cases (73.9%), while cardioplegic arrest was employed in 14 (60.9%). Epicardial CAF ligation
was utilized in 10 patients (43.5%), the transcoronary approach in 9 (39.1%), the endocardial
approach in 2 (8.7%), and other methods in 2 patients (8.7%). The application of
cardioplegic arrest during repair did not significantly impact the duration of postoperative
intensive care unit stay or overall hospital stay. One in-hospital death and 1 late death were
recorded. The overall survival rate was 95.7% at 10 years and 83.7% at 15 years. A residual
fistula was detected in 1 patient. During the follow-up period, no surviving patient experienced
cardiovascular symptoms or coronary events.
Conclusion: Surgical repair of CAF can be performed safely with or without cardioplegic
arrest, and it is associated with a favorable prognosis in children. |
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| ISSN: | 2765-1606 2765-1614 |