[Surgical treatment of congenital fistulas of the coronary artery].

PURPOSE: To evaluate the surgical result of the cases of congenital fistulae of the coronary artery.

METHODS

Seven patients were surgically treated since January 80 until February 94. The ages ranged from 3 days to 52 years old. The diagnosis was suspected by echocardiogram and established by cardiac catheterization.

RESULTS

Regarding the clinical status, 3 (42.85%) patients were asymptomatic, 3 (42.85%) presented congestive heart failure and 1 (14.28%) precordial pain and palpitation. The fistulae, located in inferior wall of the right ventricle in 1 (14.28%) patient, apex of the right ventricle in 1 (14.28%), right atrium in 3 (42.85%), and coronary sinus in 1 (14.28%), were isolated in 4 (57.17%), 1 (14.28%) also had fixed subaortic stenosis, 1 (14.28%) had previously undergone the ligate of the ductus arteriosus and 1 (14.28%) also had aortic coarctation and ductus arteriosus. After surgical treatment, 5 (85.72%) had follow up abnormalities, showing good clinical outcome; 1 (14.28%), that also had aortic and subaortic stenosis, followed with minimal aortic regurgitation and poor left ventricular performance; 1 (14.28%), that had aortic coarctation and ductus arteriosus, who had been operated on in unfavourable hemodynamic conditions, died 5 days after surgery.

CONCLUSION

Surgical correction should be proposed as a treatment of the congenital fistulae of the coronary artery, since it is technically feasible, and has low in-hospital mortality and morbidity.