Abstract
Purpose of Review
This review describes the presentation, diagnosis, and management of congenital coronary artery fistulas (CAFs) in adults.
Recent Findings
CAFs are classified as coronary-cameral or coronary arteriovenous fistulas. Fistulous connections at the distal coronary bed are more likely to be aneurysmal with higher risk of thrombosis and myocardial infarction (MI). Medium-to-large or symptomatic CAFs can manifest as ischemia, heart failure, and arrhythmias. CAF closure is recommended when there are attributable symptoms or evidence of adverse coronary remodeling. Closure is usually achievable using transcatheter techniques, though large fistulas may require surgical ligation with bypass. Given their anatomic complexity, cardiac CT with multiplanar 3-D reconstruction can enhance procedural planning of CAF closure. Antiplatelet and anticoagulation are essential therapies in CAF management.
Summary
CAFs are rare cardiac anomalies with variable presentations and complex anatomy. CAF management strategies include indefinite medical therapy, percutaneous or surgical CAF closure, and lifelong patient surveillance.
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The authors confirm that the data supporting the findings of this review are available within the article.
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J.K. and H.S. wrote the main manuscript text and Z.F. prepared the figures and tables. All authors reviewed the manuscript.
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Kanduri, J., Falk, Z. & Singh, H.S. Diagnosis and Management of Congenital Coronary Artery Fistulas in Adults. Curr Cardiol Rep (2024). https://doi.org/10.1007/s11886-024-02038-1
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DOI: https://doi.org/10.1007/s11886-024-02038-1