Percutaneous interventional occlusion of coronary artery left ventricular fistula

Objective To evaluate the methods and efficacy of percutaneous interventional closure for coronary artery left ventricular fistula (CALVF). Methods From November 2017 to January 2018, 4 CALVF patients, male 3, female 1, aged 20-37 years, average age (30.0±7.3) years were treated with percutaneous occlusion. Postoperative follow-up echocardiography, coronary CT angiography for 6 to 12 months. Results Among these 4 patients, 3 cases were right coronary artery left ventricular fistula, the other one was left circumflex left ventricular fistula. All the fistulas were wide and tortuous. The diameter of the fistulas was from 18 mm to 40 mm, average (26.5±10.0) mm. The diameter of the fistula orifice was from 7 mm to 19 mm, average (12.0±5.1) mm. Before occlusion, we establish the loop from right femoral artery to right brachial artery. All the CALVF were occluded by using of patent ductus arteriosus (PDA) occluders. Technical success was achieved in all patients, the success rate was 100%. There was no residual shunt and serious complication during follow-up. Conclusions Interventional therapy via femoral artery is safe and effective for CALVF patients with large fistula and fistula orifice. Key words: Coronary artery left ventricular fistula; Percutaneous interventional occlusion; Fistula; Fistula orifice; Patent ductus arteriosus occluder