Journal of JCIC

Objectives: The purpose of this study was to examine the long-term prognosis of coronary arterial fistula (CAF) treated by catheter intervention.

Method: Seven patients (median age 1.1 year) were enrolled who underwent catheter treatment for CAF in our institution. All cases were examined retrospectively. The median observational period was 8.1 years (minimum 3 months, maximum 22 years). Residual shunt and coronary morphology were examined by the selective coronary angiography.

Results: All patients achieved complete occlusion of CAFs. Follow-up coronary angiography showed no thrombus, nor obstruction. The morphology of coronary artery was normalized in 4 cases, revealed caliber change in 2 and blind pouch in one. Antiplatelet or anticoagulant were continued in 4 patients. The CAF was classified as distal types in 4 and proximal types in 3, and all cases were closed with various devices in the distal portion. Follow-up coronary angiography was performed in each after median 1.1 year and 5.5 years, and neither residual shunt, nor thrombus nor obstruction was recognized.

Conclusions: The long-term prognosis of catheter treatment for CAF is good. Follow-up catheterization is mandatory, and in cases where coronary artery dilatation remains or where stenosis is confirmed, the oral administration of antiplatelet agents and anticoagulants are required