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Ann Thorac Surg 2000;69:1973-1982
© 2000 The Society of Thoracic Surgeons

Current review

Traumatic coronary artery fistula management

Camille Hancock Friesen, MDa, Jonathon G. Howlett, MDb, David B. Ross, MDa

a Division of Cardiac Surgery, Dalhousie University, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
b Division of Cardiology, Dalhousie University, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada

Address reprint requests to Dr Ross, IWK Grace Health Centre, PO Box 3070, Halifax, NS, B3J 3G9 Canada
e-mail: dross{at}iwkgrace.ns.ca

Traumatic coronary artery-cameral fistulas (TCAF) are uncommon sequelae of trauma that require early surgical intervention to prevent complications. The etiology of traumatic coronary artery-cameral fistulas may be classified as accidental or iatrogenic and have distinctly different courses depending on the etiology. The two operations described for definitive surgical closure of a traumatic coronary-cameral fistula are external ligation/obliteration of the fistula (with or without bypass grafting to the coronary artery distal to the fistula) and direct repair of the fistula from within the recipient chamber. The technique of fistula closure from within the recipient chamber is associated with a reduced incidence of fistula recurrence. A case report and a collective literature review are presented.




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