Coronary Artery Fistulas in Pulmonary Atresia and Ventricular Septal Defect

• Published in: Asian cardiovascular & thoracic annals 2008-02, Vol.16 (1), p.29-32
• Main Authors: Collison, Sathiakar P, Dagar, Kulbhushan S, Kaushal, Sunil K, Radhakrishanan, Sitaraman, Shrivastava, Savitri, Iyer, Krishna S
• Format: Article
• Language: English
• Subjects: Adolescent; Anastomosis, Surgical; Arterio-Arterial Fistula - complications; Arterio-Arterial Fistula - diagnostic imaging; Arterio-Arterial Fistula - mortality; Arterio-Arterial Fistula - physiopathology; Arterio-Arterial Fistula - surgery; Cardiac Surgical Procedures; Child, Preschool; Collateral Circulation; Coronary Angiography; Coronary Vessel Anomalies - complications; Coronary Vessel Anomalies - diagnostic imaging; Coronary Vessel Anomalies - mortality; Coronary Vessel Anomalies - physiopathology; Coronary Vessel Anomalies - surgery; Female; Heart Septal Defects, Ventricular - complications; Heart Septal Defects, Ventricular - diagnostic imaging; Heart Septal Defects, Ventricular - mortality; Heart Septal Defects, Ventricular - physiopathology; Heart Septal Defects, Ventricular - surgery; Humans; Infant; Male; Pulmonary Artery - abnormalities; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - physiopathology; Pulmonary Artery - surgery; Pulmonary Atresia - complications; Pulmonary Atresia - diagnostic imaging; Pulmonary Atresia - mortality; Pulmonary Atresia - physiopathology; Pulmonary Atresia - surgery; Pulmonary Circulation; Treatment Outcome
• ISSN: 0218-4923; 1816-5370
• DOI: 10.1177/021849230801600108

Pulmonary atresia with ventricular septal defect is an anomaly with highly variable anatomy. Rarely, a coronary artery-to-pulmonary artery fistula may contribute to pulmonary blood flow. Since 1996, we have treated 4 patients with coronary-pulmonary fistula associated with pulmonary atresia and ventricular septal defect. Two fistulas originated from the left coronary, one from the right coronary, and one from a right-sided solitary coronary system. All terminated in the main pulmonary artery, which was adequate in all cases. The fistulas were managed by direct internal closure. Total intracardiac repair was then accomplished in all patients at the same sitting. There was one death. In children with favorable anatomy, direct closure of the fistula from the pulmonary artery is adequate and allows single-stage intracardiac repair.