Coronary Artery Fistulas: Indications, Techniques, Outcomes, and Complications of Transcatheter Fistula Closure

JACC Cardiovasc Interv. 2021 Jul 12;14(13):1393-1406. doi: 10.1016/j.jcin.2021.02.044.

Abstract

Coronary artery fistulas (CAFs) are rare coronary anomalies that are usually diagnosed incidentally with cardiac imaging. Small CAFs are generally asymptomatic and can close over time, while some untreated medium or large CAFs can enlarge, leading to clinical sequelae such as cardiac chamber enlargement or myocardial ischemia. With the advancement of transcatheter equipment and techniques, CAFs have been increasingly closed using a percutaneous approach. However, the procedure is not free of limitations given the risk for myocardial infarction, device embolization, and fistula recanalization. In this review, the authors illustrate the contemporary procedural considerations, techniques, and outcomes of transcatheter CAF closure.

Keywords: chest; coronary artery fistula; percutaneous closure.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / adverse effects
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Coronary Vessel Anomalies*
  • Fistula*
  • Humans
  • Treatment Outcome
  • Vascular Fistula* / diagnostic imaging
  • Vascular Fistula* / etiology
  • Vascular Fistula* / therapy