Original article: cardiovascularCoronary artery fistulas: long-term results of surgical correction
Section snippets
Patients and methods
Between 1968 and 1997, 41 patients with congenital coronary artery fistulas were admitted to the Department of Surgery, the Grantham Hospital, Hong Kong. All of them had surgical correction. Preoperative workup included roentgenographic, electrocardiographic, echocardiographic, and angiographic studies. The origin and sites of entry of the fistulas were defined and the degree of shunting calculated. Other concomitant cardiac abnormalities were also noted. Operation consisted of obliteration of
Results
Forty-one patients with coronary artery fistula were operated in the past 30 years between 1968 and 1997. The mean age was 23.2 ± 1.6 years (one standard deviation), the youngest was 2.3 years old and the oldest 58. Nineteen were men and 22 were women. Among this group of patients, only 28 were symptomatic (68.3%) of which 14 (77.8%) were more than 20 years old. Twelve of the 14 asymptomatic patients were younger than 20 years. Three patients were asymptomatic when the fistula was first
Comment
Congenital coronary artery fistula was first described by Krause in 1865, but it was not until 1958 that Fell and colleagues [2] described the first successful surgical treatment. Accurate clinical diagnosis was extremely difficult without the help of coronary angiograms and patients were not uncommonly explored with a presumptive diagnosis of a patent ductus arteriosus, a ruptured sinus of Valsalva, a ventricular septal defect with aortic regurgitation, an aortopulmonary window, an
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