Long‐term outcomes following surgical repair of coronary artery fistula in adults

Background and aim of the study: Coronary artery fistula (CAF) is a relatively rare cardiac anomaly. We investigated long-term outcomes following surgical repair of CAF in adults. Methods: We retrospectively investigated 13 consecutive patients undergoing surgical repair of CAF in our institution between 2008 and 2019 (67.3±10.4 years old, 38% male). CAF types were coronary artery-pulmonary artery fistula (77%), coronary artery-coronary sinus fistula (15%), and both (8%). CAFs originated from the left coronary artery (38%), right coronary artery (8%), and bilateral coronary arteries (38%). Pulmonary and systemic flow (Qp/Qs) was measured in seven patients (54%), with a mean value of 1.52. Seven patients underwent surgery for CAFs alone, and others simultaneously underwent surgery for comorbid cardiac diseases. Results: All procedures were conducted under cardiopulmonary bypass. Surgical procedures were direct epicardial ligation of fistula (92%), direct closure of CAF through pulmonary artery incision (38%), direct closure of CAF through coronary sinus incision (8%), or patch closure of CAF through coronary artery incision (8%). Myocardial perfusion scintigraphy showed asymptomatic myocardial ischemia in the right coronary area after surgery in one patient. There were no deaths perioperatively or during follow-up (mean 66.6 months). There were no coronary or other CAF-related events. Conclusions: Several anatomical variations in CAF were observed which coexist with cardiac disease. Long-term outcomes following surgical repair were satisfactory, and the concurrent intervention of CAFs during surgery for comorbid cardiac disease is useful to prevent future complications related CAFs in adults.

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Closure of Isolated Congenital Coronary Artery Fistula: Long-Term Outcomes and Rate of Re-intervention

Pediatric Cardiology ◽

10.1007/s00246-015-1224-3 ◽

2015 ◽

Vol 36 (8) ◽

pp. 1728-1734 ◽

Cited By ~ 6

Author(s):

Laure Ponthier ◽

Philippe Brenot ◽

Virginie Lambert ◽

Jérôme Petit ◽

Jean-Yves Riou ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Fistula ◽

Long Term Outcomes ◽

Congenital Coronary Artery Fistula

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Long-Term Outcomes of Coronary-Artery Bypass Grafting Versus Stent Implantation

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70422-6 ◽

2007 ◽

Vol 2007 ◽

pp. 100-101

Author(s):

G.L. Moneta

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Stent Implantation ◽

Artery Bypass ◽

Bypass Grafting ◽

Long Term Outcomes ◽

Artery Bypass Grafting

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Long-term Outcomes Following Surgical Repair of Persistent Truncus Arteriosus (PTA)

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0036-1571578 ◽

2016 ◽

Vol 64 (S 01) ◽

Author(s):

M. Rahatianpur ◽

F. Bakhtiary ◽

H. Seki ◽

M. Kostelka

Keyword(s):

Surgical Repair ◽

Truncus Arteriosus ◽

Long Term Outcomes ◽

Persistent Truncus Arteriosus

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Impact of established cardiovascular disease on 10-year death after coronary revascularization for complex coronary artery disease

Clinical Research in Cardiology ◽

10.1007/s00392-021-01922-y ◽

2021 ◽

Author(s):

Rutao Wang ◽

Scot Garg ◽

Chao Gao ◽

Hideyuki Kawashima ◽

Masafumi Ono ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Revascularization ◽

Long Term Outcomes ◽

Vital Status ◽

Increased Risk ◽

Artery Disease ◽

The Impact

Abstract Aims To investigate the impact of established cardiovascular disease (CVD) on 10-year all-cause death following coronary revascularization in patients with complex coronary artery disease (CAD). Methods The SYNTAXES study assessed vital status out to 10 years of patients with complex CAD enrolled in the SYNTAX trial. The relative efficacy of PCI versus CABG in terms of 10-year all-cause death was assessed according to co-existing CVD. Results Established CVD status was recorded in 1771 (98.3%) patients, of whom 827 (46.7%) had established CVD. Compared to those without CVD, patients with CVD had a significantly higher risk of 10-year all-cause death (31.4% vs. 21.7%; adjusted HR: 1.40; 95% CI 1.08–1.80, p = 0.010). In patients with CVD, PCI had a non-significant numerically higher risk of 10-year all-cause death compared with CABG (35.9% vs. 27.2%; adjusted HR: 1.14; 95% CI 0.83–1.58, p = 0.412). The relative treatment effects of PCI versus CABG on 10-year all-cause death in patients with complex CAD were similar irrespective of the presence of CVD (p-interaction = 0.986). Only those patients with CVD in ≥ 2 territories had a higher risk of 10-year all-cause death (adjusted HR: 2.99, 95% CI 2.11–4.23, p < 0.001) compared to those without CVD. Conclusions The presence of CVD involving more than one territory was associated with a significantly increased risk of 10-year all-cause death, which was non-significantly higher in complex CAD patients treated with PCI compared with CABG. Acceptable long-term outcomes were observed, suggesting that patients with established CVD should not be precluded from undergoing invasive angiography or revascularization. Trial registration SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. Graphic abstract

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Serial coronary CT angiography–derived fractional flow reserve and plaque progression can predict long-term outcomes of coronary artery disease

European Radiology ◽

10.1007/s00330-021-07726-y ◽

2021 ◽

Author(s):

Liu Yang ◽

Peng Peng Xu ◽

U. Joseph Schoepf ◽

Christian Tesche ◽

Balakrishnan Pillai ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Ct Angiography ◽

Plaque Progression ◽

Fractional Flow ◽

Long Term Outcomes ◽

Coronary Ct ◽

Flow Reserve ◽

Artery Disease

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Single coronary artery and neonatal arterial switch operation: early and long-term outcomes†

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezx046 ◽

2017 ◽

Vol 52 (1) ◽

pp. 90-95 ◽

Cited By ~ 7

Author(s):

Sébastien Gerelli ◽

Margaux Pontailler ◽

Bruno Rochas ◽

Emanuela Angeli ◽

Mathieu Van Steenberghe ◽

...

Keyword(s):

Coronary Artery ◽

Arterial Switch Operation ◽

Single Coronary Artery ◽

Long Term Outcomes ◽

Arterial Switch ◽

Switch Operation

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Abstract 16231: Long-term Outcomes of Coronary Artery Bypass Grafting versus Percutaneous Coronary Intervention in Patients With Non-st Elevation Acute Coronary Syndrome

Circulation ◽

10.1161/circ.142.suppl_3.16231 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Kiro Barssoum ◽

Ashish Kumar ◽

Devesh Rai ◽

Adnan Kharsa ◽

Medhat Chowdhury ◽

...

Keyword(s):

Coronary Artery ◽

Meta Analysis ◽

Artery Bypass ◽

Coronary Intervention ◽

Long Term Outcomes ◽

Coronary Syndrome ◽

Percutaneous Coronary ◽

St Elevation

Background: Long term outcomes of culprit multi-vessel and left main patients who presented with Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) and underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) are not well defined. Randomized trials comparing the two modalities constituted mainly of patients with stable coronary artery disease (SCAD). We performed a meta-analysis of studies that compared the long term outcomes of CABG vs. PCI in NSTE-ACS. Methods: Medline, EmCare, CINAHL, Cochrane databases were queried for relevant articles. Studies that included patients with SCAD and ST-elevation myocardial infarction were excluded. Our primary outcome was major adverse cardiac events (MACE) at 3-5 years, defined as a composite of all-cause mortality, stroke, re-infarction and repeat revascularization. The secondary outcome was re-infarction at 3 to 5 years. We used the Paule-Mandel method with Hartung-Knapp-Sidik-Jonkman adjustment to estimate risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was assessed using Higgin’s I 2 statistics. All statistical analysis was carried out using R version 3.6.2 Results: Four observational studies met our inclusion criteria with a total number of 6695 patients. At 3 to 5 years, the PCI group was associated with a higher risk of MACE as compared to CABG, (RR): 1.52, 95% CI: 1.28 to 1.81, I 2 =0% (PANEL A). The PCI group also had a higher risk of re-infarctions during the period of follow up, RR: 1.88, 95% CI 1.49 to 2.38, I 2 =0% (PANEL B). Conclusion: In this meta-analysis, CABG was associated with a lower risk of MACE and re-infarctions as compared to PCI during 3 to 5 years follow up period.

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