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Les fistules coronaires, un problème d’actualité : approche clinique et considérations thérapeutiques

Authors
  • Tiritilli, A.
  • Iaria, P.
  • Viard, P.
  • Sayah, S.
  • Benali, T.
  • Detienne, J.-P.
  • Martis, S.
  • Tchatchum, F.
  • Aouate, P.
Type
Published Article
Journal
Annales de Cardiologie et d Angéiologie
Publisher
Elsevier
Publication Date
Jan 01, 2013
Accepted Date
Apr 01, 2013
Identifiers
DOI: 10.1016/j.ancard.2013.04.006
Source
Elsevier
Keywords
License
Unknown

Abstract

The coronary fistula is a link between one or more of the coronary arteries and cardiac cavity or great vessel. The exact occurrence is unknown. The majority of these fistulas are congenital in origin. However, they may occasionally be detected after cardiac surgery. For a long time, fistulas are asymptomatic, especially if they are small; the frequency of the symptoms and especially the complications rise with age. The potential complications are: cardiac failure, endocarditis, endarteritis, atrial fibrillation, ventricular arrhythmias, rupture, and thrombosis. The main differential diagnosis is patent arterial duct, while other congenital arteriovenous shunts need to be excluded. Even though echocardiography Doppler can help to differentiate shunts, the coronary angiography remains the main diagnostic tool for the description of the anatomy. For a long time, the surgery was the only therapeutic means, up till now, percutaneous occlusion is the first line therapy of coronary fistulas and that the different devices can be tailored to meet different anatomic and functional characteristics.

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