1 Assistant Professor of Pediatric Cardiology, Shahrekord University of Medical Sciences

2 Associate Professor of Pediatrc Cardiology, Shaheed Rajaie Cardiovascular Medical Center

3 Associate Professor of Pediatrc Cardiology , Dr. Shariati Hospital, Tehran University of Medical Sciences


Background- Coronary artery fistula (CAF) is a rare congenital anomaly that can be ‎complicated by endocarditis, myocardial infarction or coronary aneurysms. The ‎purpose of this article is to review the clinical characteristics and surgical outcome in ‎‎10 patients with CAF‏.‏‎
‎ Methods- From 1990 to 2000, ten patients (aged 6 months to 15 years with a mean of ‎‎8.5 years) were diagnosed with CAF via echocardiography and cardiac ‎catheterization. Six were female and 4 were male. All the patients with isolated CAF ‎‎(9) were asymptomatic. One patient with associated anomaly (MVP with severe MR) ‎had dyspnea on exertion and palpitation‏.‏‎
‎ Results- Five fistulas originated from the right coronary artery, three from the left and ‎two from the left circumflex. Drainage was to the right ventricle (7), right atrium (2) ‎and pulmonary artery (1). The ratio of pulmonary to systemic flows ranged between 1 ‎to 1.6. All the patients had surgical ligation. In the symptomatic patient, in addition to ‎ligation, mitral valve replacement was performed. There was no operative or late ‎death. Follow-up evaluation ranging from 1 year to 6 years with a mean of 4.2 years ‎showed no evidence of recurrent or residual CAF‏.‏‎
‎ Conclusion- Surgical management of CAF is a safe and effective treatment, resulting ‎in 100% closure rate (Iranian Heart Journal 2003; 4 (4):35-38).‎