Journal of JCIC

Online edition: ISSN 2432–2342
JCIC学会事務局 JCIC学会事務局
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Journal of JCIC 4(2): 18-23 (2019)


冠動脈瘻に対しカテーテル治療を行った症例の長期予後に対する検討Long-term Prognosis of the Coronary Arterial Fistulae treated by catheter intervention

神奈川県立こども医療センター循環器内科Department of Cardiology, Kanagawa Children’s Medical Center

受付日:2019年5月15日Received: May 15, 2019
受理日:2020年1月31日Accepted: January 31, 2020
発行日:2020年3月31日Published: March 31, 2020

目的:冠動脈瘻(coronary arterial fistula: CAF)に対するカテーテル治療の長期的な予後を検討すること.


結果:CAFは遠位型4例,近位型3例であった.全例,冠動脈の末梢側に各種デバイスを留置しCAFを閉塞した.中央値1年2ヶ月後と5年7ヶ月後に冠動脈造影を施行し,全例CAFは完全閉塞し,血栓形成や閉塞も認めなかった.形態については,正常化4例,caliber change 2例,盲端1例であり,4例では,抗血小板剤や抗凝固薬の内服を継続している.


Objectives: The purpose of this study was to examine the long-term prognosis of coronary arterial fistula (CAF) treated by catheter intervention.

Method: Seven patients (median age 1.1 year) were enrolled who underwent catheter treatment for CAF in our institution. All cases were examined retrospectively. The median observational period was 8.1 years (minimum 3 months, maximum 22 years). Residual shunt and coronary morphology were examined by the selective coronary angiography.

Results: All patients achieved complete occlusion of CAFs. Follow-up coronary angiography showed no thrombus, nor obstruction. The morphology of coronary artery was normalized in 4 cases, revealed caliber change in 2 and blind pouch in one. Antiplatelet or anticoagulant were continued in 4 patients. The CAF was classified as distal types in 4 and proximal types in 3, and all cases were closed with various devices in the distal portion. Follow-up coronary angiography was performed in each after median 1.1 year and 5.5 years, and neither residual shunt, nor thrombus nor obstruction was recognized.

Conclusions: The long-term prognosis of catheter treatment for CAF is good. Follow-up catheterization is mandatory, and in cases where coronary artery dilatation remains or where stenosis is confirmed, the oral administration of antiplatelet agents and anticoagulants are required

Key words: Coronary artery fistula; transcatheter closure; Amplatzer Vascular Plug; antiplatelet agent; anticoagulant

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