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Sameh M. Said, MD, Harold M. Burkhart, MD, Hartzell V

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Presentation on theme: "Sameh M. Said, MD, Harold M. Burkhart, MD, Hartzell V"— Presentation transcript:

1 Late outcome of repair of congenital coronary artery fistulas—a word of caution 
Sameh M. Said, MD, Harold M. Burkhart, MD, Hartzell V. Schaff, MD, Heidi M. Connolly, MD, Sabrina D. Phillips, MD, Rakesh M. Suri, MD, DPhil, Ben Eidem, MD, Charanjit S. Rihal, MD, Joseph A. Dearani, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 145, Issue 2, Pages (February 2013) DOI: /j.jtcvs Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Intraoperative photographs showing some congenital coronary artery fistula types encountered in our series. A, Right coronary artery (RCA) aneurysm in patient with RCA-to-coronary sinus fistula; B, large dilated and tortuous circumflex (Cx) coronary artery in patient with Cx-to-coronary sinus fistula; C, left anterior descending (LAD)-to-pulmonary artery (PA) fistula with multiple collaterals visualized on anterior surface of PA; and D, dilated RCA in patient with RCA-to-right atrial fistula. RA, Right atrium; Ao, aorta. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Illustrations of some surgical techniques used in repairing coronary fistulas. A, Direct epicardial ligation of fistula while preserving distal coronary artery flow; and B, transcoronary approach for closure of fistula, which is possible in the case of a large dilated coronary artery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Intraoperative photographs showing A, excised portion of right coronary artery (RCA) with associated aneurysm. In 1 patient with large RCA aneurysm, the aneurysm was opened, B, the excess wall was excised, C, a segment of the saphenous vein was used as an interposition graft to maintain flow to D, the distal portion of the RCA. SVG, Saphenous vein graft; CAA, coronary artery aneurysm; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Kaplan-Meier survival curves. A, Overall survival of patients in study and B, survival compared with age- and gender-matched population. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

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