Author/Authors :
Takahashi, Shin Department of Pediatrics - School of Medicine - Iwate Medical University, Morioka, Japan , Takizawa, Yurie Department of Pediatrics - School of Medicine - Iwate Medical University, Morioka, Japan , Nakano, Satoshi Department of Pediatrics - School of Medicine - Iwate Medical University, Morioka, Japan , Koizumi, Junichi Department of Cardiovascular Surgery - School of Medicine - Iwate Medical University, Morioka, Japan , Oyama, Kotaro Department of Pediatrics - School of Medicine - Iwate Medical University, Morioka, Japan
Abstract :
The case of a patient in whom hemodynamic and electrocardiographic studies using the occlusion test for coronary artery fistulas
(CAF) were safely performed prior to catheter embolization is reported. A 1-year-old girl had a separate right coronary artery
arising from a left single coronary artery that formed a significant coronary artery fistula to the right ventricle. Coronary steal by
the large coronary artery fistula narrowed the left coronary artery. The right coronary artery branches could not be clearly
identified due to an overlap with the fistula. Due to the long porous CAF, embolic procedures could cause serious
complications. We confirmed the safety by performing an occlusion test of the CAF’s proximal blood vessels. Following total
occlusion of the CAF for 10 minutes, pulmonary arterial pressure and aortic blood pressure were not significantly changed. No
bradycardia, atrioventricular block, or ST changes were observed. Coil embolization treatment was performed safely. For
patients with long distal CAF complicated with a single coronary artery, myocardial ischemia and conduction system disorders
can be identified by performing the occlusion test before embolization.
Keywords :
Coil Embolization , Single Coronary Artery , Fistula , Occlusion Test
