PERCUTANEOUS TRANSCATHETER EMBOLIZATION OF CORONARY ARTERIOVENOUS-FISTULAS

Coronary artery fistulas are infrequently encountered vascular communi cations that are either congenital or due to cardiac trauma. Most pati ents with these anomalies are asymptomatic, but late complications can occur and include congestive heart failure, myocardial ischemia, arrh ythmias, and endocarditis, Therefore, many investigators have recommen ded surgical repair, even for asymptomatic patients, Although coronary arteriovenous fistulas pose many challenges to interventional cardiol ogists, early experiences suggest that these abnormal vessels can be s uccessfully obliterated percutaneously; thus, the patient is spared th e risks and morbidity associated with cardiac surgical intervention, H erein we present two cases that illustrate many of the technical issue s involved in successful transcatheter embolization of coronary artery fistulas.