Transcatheter Closure of Coronary Artery Fistulae: A Literature Review

Coronary artery fistulae (CAFs) are anomalous connections that bypass the myocardial capillary bed between 1 or more coronary arteries and other cardiac chambers or other vessels. These fistulae are usually asymptomatic and are, thus, diagnosed incidentally. However, larger CAFs can cause various symptoms such as angina, exertional dyspnea, syncope, palpitation, and even sudden cardiac death. Treatment options include surgical closure and percutaneous transcatheter closure (TCC) with comparable safety and efficacy. The choice of device in TCC depends on the anatomic characteristics of the CAF, the age and size of the patient, the size of the occluded vessel, the appropriate size of the catheter to be used, and the tortuosity of the catheter course to reach the intended point. Herein, we present 4 cases treated via TCC and then offer an in-depth discussion regarding this coronary artery anomaly.