Angiographic and Clinical Manifestations of Coronary Fistulas in Chinese People 15-Year Experience

Chiung-Zuan Chiu; Kou-Gi Shyu; Jun-Jack Cheng; Shen-Chang Lin; Shih-Huang Lee; Huei-Fong Hung; Jer-Young Liou

doi:10.1253/circj.72.1242

Clinical Investigation

Angiographic and Clinical Manifestations of Coronary Fistulas in Chinese People

15-Year Experience

Chiung-Zuan Chiu, Kou-Gi Shyu, Jun-Jack Cheng, Shen-Chang Lin, Shih-Huang Lee, Huei-Fong Hung, Jer-Young Liou

Author information

Chiung-Zuan Chiu
School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
Graduate Institute of Clinical Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Kou-Gi Shyu
Graduate Institute of Clinical Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Jun-Jack Cheng
School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
School of Medicine, Taipei Medical University, Taipei, Taiwan
Shen-Chang Lin
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Shih-Huang Lee
School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Huei-Fong Hung
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Jer-Young Liou
Division of Cardiology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

Keywords: Congenital anomaly, Coronary artery fistula, Coronary artery lesions, Heart failure, Myocardial ischemia

JOURNAL FREE ACCESS

2008 Volume 72 Issue 8 Pages 1242-1248

DOI https://doi.org/10.1253/circj.72.1242

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Abstract

Background Coronary artery fistula (CAF) is an anomaly resulting in the steal phenomenon of coronary blood flow, which may cause morbidity or mortality. CAFs in Chinese patients after long-term follow-up of 15 years were retrospectively analyzed. Methods and Results From September, 1992 to August, 2007, 152 CAFs were detected in 28,210 coronary angiograms from 125 patients. Clinical and angiographic data of all patients were analyzed retrospectively. Two types of CAFs were characterized: type I in 99 patients with 124 solitary coronary to cardiac chamber or great vessel fistula; type II: 26 patients with 28 coronary artery - left ventricular multiple microfistulas. Single-, double-, and triple-CAFs were detected in 79%, 20%, and 1% of patients, respectively. Coexistent coronary lesions were noted in 41% of patients. Fistula-related symptoms included stable angina in 55, myocardial infarction in 2, heart failure in 2, sudden death with ventricular fibrillation in 1, and syncope in 1. Twenty-four patients had coexistent congenital anomalies. Only 9 patients underwent coronary intervention or/and surgery for CAFs. Conclusions CAFs may cause trivial or lethal cardiac events, and may coexist with coronary lesion or congenital anomaly. Coronary to cardiac chamber or great vessel fistula and coronary-left ventricular multiple microfistulas have different morphologic and pathological phenomena. (Circ J 2008; 72: 1242 -1248)

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