SURGICAL-TREATMENT OF CORONARY-ARTERY FISTULAS ASSOCIATED WITH OTHER CARDIOVASCULAR ANOMALIES

Objective. To evaluate retrospectively our surgical experience, techni ques and long-term results in 11 patients with coronary artery fistula e associated with other cardiovascular anomalies. Methods. From Januar y 1980 to April 1995, 11 patients with coronary artery fistulae associ ated with other cardiovascular anomalies were found among 20 000 open- heart procedures and treated surgically. Besides closure of the fistul ae, coronary artery bypass grafting was performed in 5 patients with a therosclerotic coronary artery disease, and aneurysm angioplasty was d one in 4 patients with coronary artery aneurysm. Ventricular septal de fect and patent ductus arteriosus were closed in one patient and mitra l valve replacement was performed in another patient. Results. There w ere no surgical deaths, but one late death due to acute myocardial inf arction occurred 6 months after surgery. The mean follow-up time was 7 5.7 months and all patients' functional Status improved by an average 1.4 judged by the New York Heart Association functional classification . Conclusions. Coronary artery fistula associated with other cardiovas cular anomalies will aggravate symptoms and cause deterioration of hea rt function. Therefore, evaluation and surgical intervention should be done as soon as possible to restore coronary blood flow and correct c oncomitant cardiovascular anomalies. The surgical results are excellen t with a low operative risk and good long-term results.