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Ann Thorac Surg 1994;58:760-763
© 1994 The Society of Thoracic Surgeons

Articles

Coronary artery fistula in the pediatric age group: A 19-year institutional experience

J.Terrance Davis, MD*, Hugh D. Allen, MD, John J. Wheller, MD, David P. Chan, MD, Daniel M. Cohen, MD, Douglas W. Teske, MD, Steven C. Cassidy, MD, Jo M. Craenen, MD, James W. Kilman, MD

Departments of Surgery and Pediatrics, Ohio State University, College of Medicine, Children's Hospital, Columbus, Ohio USA

Accepted for publication January 11, 1994.

* Address reprint requests to Dr Davis, Department of Thoracic Surgery. Children's Hospital, 700 Children's Drive, Columbus, OH 43205.

Ten patients with coronary artery fistulae were identified from records at Columbus Children's Hospital between 1974 and 1993. Clinical presentations of patients were quite variable, from 1 day to 20 years of age. Symptoms ranged from none to severe cardiorespiratory failure requiring extracorporeal membrane oxygenation. Long term follow-up revealed one sudden death and one spontaneous closure of the fistula. This lesion should be ruled out in patients who present as extracorporeal membrane oxygenation candidates. Patients with mild forms of this lesion may be followed up medically if the left to right shunt is inconsequential, because spontaneous closure is a possibility. Because of the risk of sudden death, close long-term follow-up is mandatory even for operated patients, and antiplatelet therapy should be considered for these patients.




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