Abdurrahman ÜNER, Mehmet TÜRE, İbrahim ECE, Musa ŞAHİN

Successful closure of coronary artery fistula with an Amplatzer Duct Occluder II device

Koroner arterler ile kalp boşlukları arasında koroner arter fistülleri nadir görülen doğuştan kalp anomalileridir. Bu fistüllerin geleneksel tedavisi cerrahi olmasına rağmen, seçilmiş olgularda transkateter olarak da kapatılması uygundur. Bu makalede, sağ koroner arter ve sağ atriyum arasında yerleşimli fistülün Amplatzer Duct Occluder II cihazı ile başarılı bir şekilde kapatıldığı bir olgu sunuldu. On bir aylık hasta devamlı üfürüm nedeni ile kliniğimize getirildi. Fizik muayenesinde başka bir patoloji saptanmadı. Transtorasik ekokardiyografide koroner arter ve sağ atriyum arasında yerleşimli bir fistül izlendi. Fistül Amplatzer Duct Occluder II cihazı ile antegrad olarak kapatıldı. İşlem sonrası ekokardiyografisinde fistül yolunda devam eden akım görülmedi.

Koroner arter fistülünün Amplatzer Duct Occluder II cihazı ile başarılı kapatılması

Coronary artery fistulas localized between the coronary arteries and heart chambers are rare congenital abnormalities of the heart. Although surgery is the conventional treatment of these fistulas, transcatheter closure is feasible in selected cases. Herein, we present a case in whom the fistula was localized between the coronary artery and right atrium and successfully closed with an Amplatzer Duct Occluder II. An 11-month-old patient was admitted to our clinic with a continuous murmur. His physical examination revealed no other pathology. Transthoracic echocardiography showed a fistula localized between the coronary artery and right atrium. The fistula was closed antegradely with an Amplatzer Duct Occluder II device. Post-procedural echocardiography revealed no continuous flow across the fistulous tract.

PDF

___

Uthaman B, Al-Qbandi M, Abushaban L, Rathinasamy J. Transcatheter closure of large pulmonary arteriovenous fistula including pulmonary artery to left atrial fistula with Amplatzer septal occluder. Catheter Cardiovasc Interv 2007;70:422-8.
Behera SK, Danon S, Levi DS, Moore JW. Transcatheter closure of coronary artery fistulae using the Amplatzer Duct Occluder. Catheter Cardiovasc Interv 2006;68:242-8.
Kilic H, Akdemir R, Bicer A, Dogan M. Transcatheter closure of congenital coronary arterial fistulas in adults. Coron Artery Dis 2008;19:43-5.
Kung GC, Moore P, McElhinney DB, Teitel DF. Retrograde transcatheter coil embolization of congenital coronary artery fistulas in infants and young children. Pediatr Cardiol 2003;24:448-53.
Ece I, Uner A, Cuce F, Sahin M. Transcatheter closure of tortuous aorto-right atrial fistula. Cardiovasc Interv Ther 2015;30:151-4.
Ömeroğlu SN, Mataracı İ, Rabuş MB, İpek G, Yakut C. Surgical treatment of a coronary artery fistula originating from the left anterior descending artery. Turk Gogus Kalp Dama 2005;13:3:303-4.
Levin DC, Fellows KE, Abrams HL. Hemodynamically significant primaryanomalies of the coronary arteries. Circulation 1978;58:25-34.
Tirilomis T, Aleksic I, Busch T, Zenker D, Ruschewski W, Dalichau H. Congenital coronary artery fistulas in adults: surgical treatment and outcome. Int J Cardiol 2005;98:57-9.
Gajjar T, Voleti C, Matta R, Iyer R, Dash PK, Desai N. Aorta-right atrial tunnel: clinical presentation, diagnostic criteria, and surgical options. J Thorac Cardiovasc Surg 2005;130:1287-92.
Armsby LR, Keane JF, Sherwood MC, Forbess JM, Perry SB, Lock JE. Management of coronary artery fistulae. Patient selection and results of transcatheter closure. J Am Coll Cardiol 2002;39:1026-32.
Christoph MH, Kamal N, Harald B. Embolotherapy in giant pulmonary arteriovenous malformation: blocking the exit-reducing the risk of peri-interventional stroke. JACC Cardiovasc Interv 2012;5:997-8.