Angiographic characteristics of coronary artery fistulas.

OZET C artery fistulas (CAFs) are abnormal communications between a coronary artery and a cardiac chamber or major vessel (vena cava, pulmonary veins, pulmonary artery, coronary sinus). They may be congenital or acquired due to trauma and iatrogenic causes. Angiographic series have revealed that the frequency of CAF is approximately 0.1-0.8% in adults. Many of these patients are asymptomatic and are diagnosed during coronary angiography incidentally. Hence, the natural history of CAFs remains unclear. [1-4] The hemodynamic consequences of the fistula vary depending on shunt size, shunt site and presence of other underlying cardiac diseases.[4,5] Several complications, including bacterial endocarditis, thrombosis, aneurysm formation, dissection, rupture, premature atherosclerosis, pulmonary hypertension, myocardial ischemia, or infarction, related to large or multiple fistulas, have been reported.[5] The management of CAFs is controversial, and recommendations are based on anecdotal cases or small retrospective series.[5-12] Data about the angiographic characteristics of these patients are inadequate. In this study, one of the largest series in the literature, we defined the angiographic characteristics of CAFs in Turkish patients. PATIENTS AND METHODS