Clinical and Angiographic Findings and Surgery Results in Coronary Arteriovenous Fistula

Although coronary arteriovenous fistula (CAVF) is uncommon but it accounts half of congenital anomalies of the coronary arteries. The aim of this study is to evaluate clinical findings, origin and result of surgery in a group of patients with CAVF. In this multicenter study patients with the diagnosis of CAVF who admitted in Tehran Shahid Rajaee hospital and Tabriz Shahid Madani hospital were selected. In all patients, demographic data, clinical, and imaging findings and also results of surgery were collected. Between 1988-2006, 18 (11 were male and 7 female, 3-58 years) CAVF patients were admitted. 13 patients were less than 20 years old and 5 over 20. In 12 patients (66.5%) CAVF originate from the right coronary artery and in six patients (33.5%) from the left. Most common site of termination of CAVF was right ventricle (50%). There was not any CAVF to left side of the heart. Surgical closures of CAVF were performed in 16 patients, in 14 of them fistula were closed by cardiopulmonary bypass (CPB). Careful investigation is recommended for diagnosis of CAVF. It should be considered in the differential diagnosis of potent ductus arteriosus. Operation is indicated for CAVF patient with significant shunt.