CORONARY-ARTERY FISTULA IN THE PEDIATRIC AGE GROUP - A 19-YEAR INSTITUTIONAL EXPERIENCE

Ten patients with coronary artery fistulae were identified from record s at Columbus Children's Hospital between 1974 and 1993. Clinical pres entations of patients were quite variable, from 1 day to 20 years of a ge. Symptoms ranged from none to severe cardiorespiratory failure requ iring extracorporeal membrane oxygenation. Long term follow-up reveale d one sudden death and one spontaneous closure of the fistula. This le sion should be ruled out in patients who present as extracorporeal mem brane oxygenation candidates. Patients with mild forms of this lesion may be followed up medically if the left to right shunt is inconsequen tial, because spontaneous closure is a possibility. Because of the ris k of sudden death, close long-term follow-up is mandatory even for ope rated patients, and antiplatelet therapy should be considered for thes e patients.