Predictors of long-term adverse outcomes in patients with congenital coronary artery fistulae

Anne Marie Valente, James E. Lock, Kimberlee Gauvreau, Elizabeth Rodriguez-Huertas, Caitlyn Joyce, Laurie Armsby, Emile A. Bacha, Michael J. Landzberg

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background:Significant morbidities, including angina, symptomatic heart failure, and myocardial infarction, have been reported after coronary artery fistula (CAF) closure; however, predictors that may be associated with adverse outcomes have not been established. The goal of this investigation is to describe the long-term outcomes witnessed in patients with either treated or untreated CAF at our institution and to investigate whether certain features predicted adverse outcomes. Methods and Results:The records and angiograms of patients with CAF who underwent a diagnostic cardiac catheterization at Children's Hospital Boston from 1959 through 2008 were reviewed. Of 76 patients identified, 20% were associated with additional congenital heart disease. Forty-four underwent transcatheter closure, 20 underwent surgical repair, and no intervention was performed in the remaining 12 subjects. Three patients who had initially undergone surgical closure had a second intervention, 1 underwent repeat surgery, and 2 underwent transcatheter closure. One patient who had undergone transcatheter closure underwent a second transcatheter closure for residual fistula. Major complications, including myocardial infarction, angina with coronary thrombosis, and symptomatic cardiomyopathy, occurred in 11 (15%) patients. The sole angiographic feature that was predictive of adverse outcome was drainage of the CAF into the coronary sinus (P

Original languageEnglish (US)
Pages (from-to)134-139
Number of pages6
JournalCirculation: Cardiovascular Interventions
Volume3
Issue number2
DOIs
StatePublished - Apr 2010

Fingerprint

Fistula
Coronary Vessels
Myocardial Infarction
Coronary Thrombosis
Coronary Sinus
Cardiac Catheterization
Cardiomyopathies
Reoperation
Drainage
Heart Diseases
Angiography
Heart Failure
Morbidity

Keywords

  • Complication
  • Congenital
  • Coronary disease
  • Fistula

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Predictors of long-term adverse outcomes in patients with congenital coronary artery fistulae. / Valente, Anne Marie; Lock, James E.; Gauvreau, Kimberlee; Rodriguez-Huertas, Elizabeth; Joyce, Caitlyn; Armsby, Laurie; Bacha, Emile A.; Landzberg, Michael J.

In: Circulation: Cardiovascular Interventions, Vol. 3, No. 2, 04.2010, p. 134-139.

Research output: Contribution to journalArticle

Valente, AM, Lock, JE, Gauvreau, K, Rodriguez-Huertas, E, Joyce, C, Armsby, L, Bacha, EA & Landzberg, MJ 2010, 'Predictors of long-term adverse outcomes in patients with congenital coronary artery fistulae', Circulation: Cardiovascular Interventions, vol. 3, no. 2, pp. 134-139. https://doi.org/10.1161/CIRCINTERVENTIONS.109.883884
Valente, Anne Marie ; Lock, James E. ; Gauvreau, Kimberlee ; Rodriguez-Huertas, Elizabeth ; Joyce, Caitlyn ; Armsby, Laurie ; Bacha, Emile A. ; Landzberg, Michael J. / Predictors of long-term adverse outcomes in patients with congenital coronary artery fistulae. In: Circulation: Cardiovascular Interventions. 2010 ; Vol. 3, No. 2. pp. 134-139.
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