Outcomes of Surgical and Transcatheter Closure of Congenital Coronary Artery Fistulas: Results from a National Audit Database

Congenital coronary arterial venous fistulae are very rare anomalies. We analyzed data from a national procedure database and identified 79 (0.09%) catheter and surgical closures of coronary fistulae out of total of 88061 procedures performed over a 12 year period. Thirty four patients (43%) underwent surgical closure while 45 (57%) patients had catheter closure. Sixty six patients (83.5%) had complete follow-up. There were no early deaths, and mortality at 10 years was 4.8%. Freedom from fistula reintervention was 91.2% for the trans catheter group vs. 100% in the surgical group (p=0.11). We found no differences in outcomes between patients with isolated fistulas and those associated with other congenital defects. Surgical or catheter treatment of coronary fistulae is attainable with no early mortality and good medium term outcomes. However, reintervention rates appear to be higher in trans catheter patients.