Transcatheter coil embolization of coronary artery fistulas

SummaryCongenital coronary artery fistulas (CAFs), which have been known since 1865, are rare congenital cardiac abnormalities. Most of the CAFs are discovered incidentally during coronary angiography. We described our experience with successful transcatheter coil embolization of CAFs in an adult, leading to improvement of symptoms. The patient had chest pain or dyspnea on exertion. The CAFs originated from the left anterior descending coronary artery and the circumflex artery. They all drained into the pulmonary trunk. The coils were implanted through a microcatheter, which was passed through a 7F guiding catheter. The coils were used to occlude the CAFs completely. The procedures were uncomplicated. Patient's chest pain or dyspnea resolved after the procedures. Although the patient had small residual flow at the CAFs from the circumflex artery at follow-up coronary angiography, the patient was asymptomatic. Therefore, we considered the coil embolization to be successful. Transcatheter closure of CAFs with coil is a valid option, and can be regarded as an acceptable alternative to surgery nowadays.