Peratrial Device Closure of a Congenital Coronary Artery Fistula through a Right Parasternal Approach: Innovative Use of Available Technology

• Published in: The Heart surgery forum Vol. 19; no. 1; p. E5
• Main Authors: Jia, Yanting, Hongxin, Li, Wenbin, Guo, Zhang, Haizhou, Zou, Chengwei
• Format: Journal Article
• Language: English
• Published: United States 16.02.2016
• Subjects: Biotechnology - instrumentation; Child, Preschool; Coronary Artery Disease - congenital; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - surgery; Equipment Design; Equipment Failure Analysis; Female; Humans; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - methods; Thoracic Surgical Procedures - instrumentation; Thoracic Surgical Procedures - methods; Treatment Outcome; Vascular Closure Devices; Vascular Fistula - congenital; Vascular Fistula - diagnostic imaging; Vascular Fistula - surgery
• ISSN: 1522-6662
• DOI: 10.1532/hsf.1250

Current treatments for congenital coronary artery fistulas (CAFs) include surgical obliteration and transcatheter occlusion. However, surgical techniques involve significant trauma. Transcatheter occlusion is performed under fluoroscopy and angiography, in which radiation injury is inevitable. We present a patient, with a CAF from the left coronary artery to the right atrium, who underwent peratrial device closure of the CAF with a right parasternal approach under transesophageal echocardiography guidance. Complete occlusion was achieved by a symmetric ventricular septal occluder. We suggest that peratrial device closure of a congenital coronary artery fistula through a right parasternal approach may be a safe and effective option.