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: |
| _version_ | 1797365926073466880 |
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| author | Youngkwan Song Eun Seok Choi Dong-Hee Kim Bo Sang Kwon Chun Soo Park Tae-Jin Yun |
| author_facet | Youngkwan Song Eun Seok Choi Dong-Hee Kim Bo Sang Kwon Chun Soo Park Tae-Jin Yun |
| author_sort | Youngkwan Song |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T16:55:57Z |
| format | Article |
| id | doaj.art-776436e6e2014395ab10ed977934060e |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-03-08T16:55:57Z |
| publishDate | 2024-01-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-776436e6e2014395ab10ed977934060e2024-01-05T02:29:28ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142024-01-01571798610.5090/jcs.23.101Surgical Management of Coronary Artery Fistulas in ChildrenYoungkwan Song0https://orcid.org/0000-0002-2272-9199Eun Seok Choi1https://orcid.org/0000-0002-0618-4686Dong-Hee Kim2https://orcid.org/0000-0002-4021-8712Bo Sang Kwon3https://orcid.org/0000-0002-0365-4339Chun Soo Park4https://orcid.org/0000-0001-8718-8904Tae-Jin Yun5https://orcid.org/0000-0002-0336-1720University of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineBackground: 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.coronary artery fistulasurgical managementchild |
| spellingShingle | Youngkwan Song Eun Seok Choi Dong-Hee Kim Bo Sang Kwon Chun Soo Park Tae-Jin Yun Surgical Management of Coronary Artery Fistulas in Children Journal of Chest Surgery coronary artery fistula surgical management child |
| title | Surgical Management of Coronary Artery Fistulas in Children |
| title_full | Surgical Management of Coronary Artery Fistulas in Children |
| title_fullStr | Surgical Management of Coronary Artery Fistulas in Children |
| title_full_unstemmed | Surgical Management of Coronary Artery Fistulas in Children |
| title_short | Surgical Management of Coronary Artery Fistulas in Children |
| title_sort | surgical management of coronary artery fistulas in children |
| topic | coronary artery fistula surgical management child |
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