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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Patients were categorized into single fistula and MCAFs groups, and anatomical characteristics and transcatheter closure outcomes were compared between the 2 groups.</div></div><div><h3>Results</h3><div>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%, <em>P</em> <!--><<!--> <!-->.001). The success rate of transcatheter closure was significantly lower for multiple fistulas compared with single fistula (64.29% vs 84.34%, <em>P</em> <!-->=<!--> <!-->.011). Multivariate regression analysis indicated that the risk of closure failure for MCAFs was 2.64 times that of single fistulas.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":21299,"journal":{"name":"Revista espanola de cardiologia","volume":"78 3","pages":"Pages 206-217"},"PeriodicalIF":5.9000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cierre percutáneo de fístulas coronarias múltiples: una clasificación anatómica basada en la angiografía por tomografía computarizada coronaria\",\"authors\":\"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\",\"doi\":\"10.1016/j.recesp.2024.06.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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%, <em>P</em> <!--><<!--> <!-->.001). 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引用次数: 0
摘要
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MCAFs与单一瘘的经导管闭合效果。方法回顾性分析阜外医院2010 ~ 2023年收治的经导管冠状动脉瘘封堵术患者的临床资料。将患者分为单瘘管组和MCAFs组,比较两组患者的解剖特征和经导管闭合结果。结果本回顾性研究纳入146例经导管关闭CAFs的患者,失败率为14.38%。146例CAFs患者中,32.19%确诊为MCAFs,其中I型、II型和III型分别占40.43%、42.55%和17.02%。与单一瘘管主要起源于右冠状动脉,终止于左心室不同,MCAFs主要同时起源于右冠状动脉和左前降支(29.79%),主要流入肺动脉(70.21%),以丛状形态的发生率显著(38.3% vs 2.02%, P <;措施)。多瘘经导管闭合成功率明显低于单瘘(64.29% vs 84.34%, P = 0.011)。多因素回归分析显示,MCAFs闭合失败的风险是单个瘘的2.64倍。结论smcaf在caf中较为常见,根据其起源和终止的数量和位置可分为3种类型。经导管关闭失败的风险在MCAFs中明显高于单个瘘管。
Cierre percutáneo de fístulas coronarias múltiples: una clasificación anatómica basada en la angiografía por tomografía computarizada coronaria
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.
期刊介绍:
Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.