PERCUTANEOUS TRANSCATHETER OCCLUSION OF CORONARY-ARTERY FISTULAS USING DETACHABLE BALLOONS

Three pediatric patients underwent successful transcatheter coronary a rtery fistula occlusion using the Debrun system. This latex balloon sy stem offers several advantages over other occlusion systems. First, th e balloon delivery and release is controlled. Second, ''test occlusion s'' can be performed that allow simultaneous balloon inflation, corona ry cineangiography, and electrocardiographic monitoring. Third, becaus e the balloons are flow-directed, they are easily positioned in proper ly chosen locations. Finally, the balloons can be constructed to suit the size of the fistula. In this study, two patients received only one balloon; in the other patient two balloons were placed in the same fi stula. All fistulas drained into either the right atrium or ventricle and were successfully occluded. After a follow-up period of up to 3 ye ars, no local or systematic reactions to the balloons were recognized. We conclude that detachable balloon occlusion of coronary artery fist ulas is a safe, effective alternative to surgical ligation in selected pediatric patients.