Coronary Arteriovenous Fistula: Percutaneous Transcatheter Coil Embolization

Background:Coronary arteriovenous(AV) fistula is a rare congenital disease, and seldom produce symptoms during childhood. However late complications can occur including congestive heart failure, myocardial ischemia, and bacterial endocarditis. Therefore surgical repair is recommended even if the patients are asymptomatic. In these days many investigators are interested in transcatheter embolization because of high procedural success rate without risks and morbidity associated with cardiac surgery. Method:Five patients(4 females and 1 male) of coronary AV fistula were treated with trans catheter coil embolization. All had symptom of chest pain. In coronary angiograms fistulous tracts were originated from left anterior descending artery(LAD) and drained to main pulmonary artery(MPA) in 4 cases. The other case had abnormal vessel from left circumflex artery(LCX) to bronchial artery. Transcatherter coil embolization were done with Judkins left guiding catheter, 018 inch Tracker or 3F Microferret catheter, and 018 inch coils. Result:The fistula tracts were completely occluded in 3 cases after coil embolization. In 2 cases with multiple fistular vessels, major fistula were occluded, but minor vessels remained. There were no procedure related complications. Conclusion:Transcatheter coil embolization may be an effective treatment modality in coronary AV fistula with excellent result and minimal complications.