Transcatheter closure of multiple coronary artery fistulas: a coronary computed tomography angiography-based anatomic classification.

IF 7.2 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Peijian Wei, Yihang Li, Fengwen Zhang, Zhongying Xu, Liang Xu, Junyi Wan, Shiguo Li, Wenbin Ouyang, Shouzheng Wang, Gejun Zhang, Gary Tse, Jeffrey Shi Kai Chan, Fang Fang, Xiangbin Pan
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Abstract

Introduction and objectives: This study aimed to retrospectively analyze the anatomical characteristics and classification of multiple coronary artery fistulas (MCAFs), and to compare the outcomes of transcatheter closure between MCAFs and single fistulas.

Methods: All patients who underwent attempts at transcatheter closure of coronary artery fistulas (CAFs) at Fuwai Hospital from 2010 to 2023 were retrospectively reviewed. Patients were categorized into single fistula and MCAFs groups, and anatomical characteristics and transcatheter closure outcomes were compared between the 2 groups.

Results: This retrospective study included 146 patients who underwent attempted transcatheter closure of CAFs, with a 14.38% failure rate. Among the 146 patients with CAFs, 32.19% were identified as having MCAFs, with types I, II, and III constituting 40.43%, 42.55%, and 17.02%, respectively. Unlike single fistulas, which predominantly originated from the right coronary artery and terminated in the left ventricle, MCAFs mainly had simultaneous origins from the right coronary artery and left anterior descending artery (29.79%), and predominantly drained into the pulmonary artery (70.21%), with a notable prevalence of plexus-like morphology (38.3% vs 2.02%, P<.001). The success rate of transcatheter closure was significantly lower for multiple fistulas compared with single fistula (64.29% vs 84.34%, P=.011). Multivariate regression analysis indicated that the risk of closure failure for MCAFs was 2.64 times that of single fistulas.

Conclusions: MCAFs are common among CAFs and can be classified into 3 types based on the number and location of their origins and terminations. The risk of failure of transcatheter closure is significantly higher in MCAFs than in single fistulas.

经导管闭合多发性冠状动脉瘘:基于冠状动脉计算机断层扫描血管造影的解剖学分类。
导言和目的:本研究旨在回顾性分析多发性冠状动脉瘘(MCAFs)的解剖学特征和分类,并比较多发性冠状动脉瘘和单发性冠状动脉瘘的经导管封堵效果:方法:回顾性研究2010年至2023年期间在阜外医院尝试经导管闭合冠状动脉瘘(CAFs)的所有患者。将患者分为单个瘘管组和 MCAFs 组,比较两组患者的解剖学特征和经导管闭合结果:这项回顾性研究纳入了146例尝试经导管闭合CAFs的患者,失败率为14.38%。在 146 名 CAFs 患者中,32.19% 被确认为患有 MCAFs,其中 I 型、II 型和 III 型分别占 40.43%、42.55% 和 17.02%。与主要起源于右冠状动脉并终止于左心室的单发瘘不同,MCAFs主要同时起源于右冠状动脉和左前降支动脉(29.79%),并主要排入肺动脉(70.21%),其神经丛样形态的发生率明显高于单发瘘(38.3% vs 2.02%,P < .001)。与单个瘘管相比,多个瘘管的经导管闭合成功率明显较低(64.29% vs 84.34%,P = .011)。多变量回归分析表明,MCAFs的闭合失败风险是单个瘘管的2.64倍:结论:MCAFs 是 CAFs 中常见的一种,可根据其起源和终止的数量和位置分为 3 种类型。MCAF经导管闭合失败的风险明显高于单个瘘管。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.70
自引率
0.00%
发文量
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