1089, either, cat:49
TRANSCATHETER OCCLUSION OF CORONARY ARTERY FISTULAE IN VIETNAM
Hieu Nguyen , Hung Pham, Pham Manh Hung, Nguyen Ngoc Quang, Pham Gia Khai, Nguyen Lan Viet, Do Doan Loi,
Vietnam Heart Institute, Hanoi, Vietnam
Objectives: We report short-term and middle-term findings in 7 patients after transcatheter closure of coronary artery fistulae (CAF) in Vietnam (from 12/2002 to 4/2004).Background: CAF may be congenital or secondary to surgical or chest trauma. Surgical ligation has been recommended in most series, with mortality ranged from 2% to 4%. Transcatheter closure of CAF has been advocated as a minimally invasive alternative to surgery.Methods: We reviewed all patients presenting with significant CAF between December 2002 and April 2004. Those with additional complex cardiac disease requiring surgical management were excluded.Results: All patients are symptomatic: congestive heart failure due to a large left to right shunt, myocardial ischemia, pulmonary hypertension and arrhythmia. Of 16 patients considered for TCC, occlusion device were placed in 7 patients at 9 procedures and included Pfm Coil in 4 patients, Amplatzer septal occluder (ASO) in 1 and multiple Gianturco Coil in 2. Post deployment angiograms demonstrated complete occlusion in 3 patients, small residual shunt in 2, moderate in 2 patients. Follow-up echocardiograms showed no shunt in 6 and moderate residual flow in only 1 patient. No major complication occurred. Devices were not attempted in 4 patients because of large fistulae, vessel tortuosity and low-weighted patients (<6kg)Conclusions: Transcatheter closure of coronary artery fistulae (CAF) in Vietnamese patients is effective with low complication.
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