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Ann Thorac Surg 2004;78:2193-2195
© 2004 The Society of Thoracic Surgeons

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Improvement of Coronary Artery Fistula Surgery by Intraoperative Imaging

Per Kristian Hol, MDa,*, Odd Geiran, MD, PhDb, Kai Andersen, MD, PhDb, Karleif Vatne, MDc, Jon Offstad, MD, PhDd, Jan Ludvig Svennevig, MD, PhDb, Erik Fosse, MD, PhDa

a The Interventional Centre, Rikshospitalet University Hospital, Oslo, Norway
b Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway
c Department of Radiology, Rikshospitalet University Hospital, Oslo, Norway
d Department of Cardiology, Rikshospitalet University Hospital, Oslo, Norway

Accepted for publication October 8, 2003.

* Address reprint requests to Dr Hol, The Interventional Centre, Rikshospitalet University Hospital, N-0027 Oslo, Norway
per.kristian.hol{at}rikshospitalet.no

Complete surgical closure of coronary artery fistulas may be difficult because of complex anatomy and often multiple sites of origin. This study therefore assessed whether intraoperative fistula imaging would contribute to and improve the final surgical result. Seven adult patients underwent operation for coronary arteriovenous fistula during a 10-year period. In all 4 patients who had image guidance, the operation was guided by immediate imaging to achieve complete and persistent closure. In contrast, 2 of 3 patients who underwent operation without image guidance had residual left-to-right shunts at follow-up. Image guidance was helpful and increased the success rate of surgical closure of coronary artery fistulas.






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