Small coronary artery fistulae in childhood: a 6-year experience of 31 cases in a tertiary paediatric cardiac centre. (14th July 2015)

• Record Type: Journal Article
• Authors: Welisch, Eva; Norozi, Kambiz; Burrill, Liz; Rauch, Ralf
• Is Part Of: Cardiology in the young. Volume 26:Number 4(2016)
• Page Start: 738
• Page End: 742
• Publication Date: 2015-07-14
• Subjects: Paediatrics, -- small coronary artery fistula, -- incidence; Pediatric cardiology -- Periodicals; 618.9212
• DOI: 10.1017/S1047951115001225
• Languages: English
• ISSNs: 1047-9511

Abstract

Abstract: Background: This study describes the incidence and course of children with small coronary artery fistulae over a period of 6 years who presented at a paediatric tertiary-care centre. Materials and methods: Age at diagnosis, mode of presentation, location (origin and drainage), and association with a cardiac defect were documented and analysed. All patients obtained an electrocardiogram, and older patients were further evaluated with an exercise treadmill test. Results: A total of 31 patients were diagnosed with coronary artery fistula via transthoracic echocardiogram and comprised 0.43% of our entire patient group. Mean age was 6.14 years (standard deviation 5.4); 16 patients (52%) had associated cardiac defects. In the remaining 15 patients, the coronary artery fistula was discovered incidentally during diagnostic work-up for heart murmur or chest pain. Among all, 26 patients (84%) had left-sided and five patients (16%) had right-sided coronary artery fistulae. All right coronary artery fistula patients had associated cardiac defects; this was true for 42% of the patients with left coronary artery fistulae. None of the patients required any intervention due to the fistula, and spontaneous closure occurred in 12 patients (39%). Conclusion: Small coronary artery fistulae in children are frequently an incidental finding, and many will close spontaneously. Our data are supportive of a conservative, observant approach in asymptomatic patients with small coronary artery fistula in the paediatric population.