ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
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Prevalence and clinical features of microfistulas between the coronary artery and left ventricle: single-center experience [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2014; 42(4): 332-338 | DOI: 10.5543/tkda.2014.25936

Prevalence and clinical features of microfistulas between the coronary artery and left ventricle: single-center experience

Mehmet Doğan, Hamza Sunman, Ahmet Akyel, Tolga Çimen, Murat Bilgin, Tolgahan Efe, Mehmet Erat, Bahtiyar Aralov, Kadriye Gayretli Yayla, Mehmet Aytürk, Sadık Açıkel, Ekrem Yeter
Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara, Turkey


OBJECTIVES
Coronary artery fistula is an infrequent malformation, and the prevalence was reported as approximately 0.1-0.4% in previous studies. However, the number of studies about microfistulas from coronary arteries to the left ventricle is inadequate, especially in the Turkish population. The purpose of this study was to evaluate the prevalence and clinical features of microfistulas in subjects undergoing coronary angiography for the assessment of coronary artery disease.

STUDY DESIGN
In this retrospective study, we researched the cardiac catheterization laboratory database between January 2008 and July 2013. The presence of microfistulas was established according to the following criteria: 1) direct filling of the heart cavity during selective coronary injection without interposing “capillary” phase or venous filling, and 2) visualization of small vessels interposed between the epicardial coronary vessels and the heart cavity and emptying into the heart.

RESULTS
Microfistulas were found in 12 (0.11%) of the 11403 coronary angiographies. There were 7 (58.3%) female patients (mean age, 70.2±10.8 years), and contemporary severe coronary artery stenosis was noted in 2 (16.7%) patients. Chest pain was the most frequently encountered complaint, followed by dyspnea. Microfistulas originated from the left anterior descending artery (100%), circumflex artery (66.7%), and right coronary artery (58.3%). In addition, multiple microfistulas were seen in 6 (50%) patients, bilateral microfistulas in 3 (25%) patients and unilateral microfistula in 3 (25%) patients, and all of them terminated in the left ventricle.

CONCLUSION
Our study found an overall incidence of microfistulas of 0.11%. Microfistula is a rare cardiac anomaly that sometimes causes cardiac symptoms; otherwise, it is detected during routine coronary angiography.

Keywords: Cardiac catheterization, coronary angiography; coronary artery disease; coronary anomaly; microfistulae.

How to cite this article
Mehmet Doğan, Hamza Sunman, Ahmet Akyel, Tolga Çimen, Murat Bilgin, Tolgahan Efe, Mehmet Erat, Bahtiyar Aralov, Kadriye Gayretli Yayla, Mehmet Aytürk, Sadık Açıkel, Ekrem Yeter. Prevalence and clinical features of microfistulas between the coronary artery and left ventricle: single-center experience. Turk Kardiyol Dern Ars. 2014; 42(4): 332-338

Corresponding Author: Hamza Sunman, Türkiye
Manuscript Language: Turkish


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

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