Surgical treatment of congenital fistulas of the coronary artery
Da Silveira, W.L.; Ostoa, D.E.; Jatene, M.B.; Barbero-Marcial, M.; Oliveira, S.A.; Jatene, A.D.
Arquivos Brasileiros de Cardiologia 65(1): 31-35
1995
ISSN/ISBN: 0066-782X PMID: 8546593 Document Number: 441912
To evaluate the surgical result of the cases of congenital fistulae of the coronary artery. Seven patients were surgically treated since January 80 until February 94. The ages ranged from 3 days to 52 years old. The diagnosis was suspected by echocardiogram and established by cardiac catheterization. Regarding the clinical status, 3 (42.85%) patients were asymptomatic, 3 (42.85%) presented congestive heart failure and 1 (14.28%) precordial pain and palpitation. The fistulae, located in inferior wall of the right ventricle in 1 (14.28%) patient, apex of the right ventricle in 1 (14.28%), right atrium in 3 (42.85%), and coronary sinus in 1 (14.28%), were isolated in 4 (57.17%), 1 (14.28%) also had fixed subaortic stenosis, 1 (14.28%) had previously undergone the ligate of the ductus arteriosus and 1 (14.28%) also had aortic coarctation and ductus arteriosus. After surgical treatment, 5 (85.72%) had follow up abnormalities, showing good clinical outcome; 1 (14.28%), that also had aortic and subaortic stenosis, followed with minimal aortic regurgitation and poor left ventricular performance; 1 (14.28%), that had aortic coarctation and ductus arteriosus, who had been operated on in unfavourable hemodynamic conditions, died 5 days after surgery. Surgical correction should be proposed as a treatment of the congenital fistulae of the coronary artery, since it is technically feasible, and has low in-hospital mortality and morbidity.