Our Summary

This research paper is about a rare heart defect called Coronary artery fistulae (CAF), which is a connection between a coronary artery and a heart chamber or blood vessel. People with this defect often don’t show symptoms, but it can cause chest pain, shortness of breath, or heart failure. This defect is usually present at birth, but a few cases have been reported as a rare event after heart surgery. The paper talks about a case where a large CAF was successfully treated in an adult patient who was experiencing chest pain and had previously undergone a surgery to remove the pericardium (the membrane enclosing the heart). The CAF was closed using a non-surgical method that involved inserting a device to block off the abnormal connection.

FAQs

  1. What are coronary artery fistulae and how common are they?
  2. What are the potential symptoms of coronary artery fistulae?
  3. What is a pericardiectomy and how does it relate to the treatment of coronary artery fistulae?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pericardiectomy is to follow all post-operative instructions carefully, including taking prescribed medications, attending follow-up appointments, and gradually resuming activities as advised by your healthcare provider. It is important to communicate any concerning symptoms or changes in your health to your doctor promptly.

Suitable For

Patients with coronary artery fistulae who are experiencing symptoms such as angina, dyspnea, or cardiac failure are typically recommended for pericardiectomy. In some cases, pericardiectomy may be necessary for patients with giant coronary artery fistulae, particularly if they are causing significant symptoms or complications. Additionally, patients with previous pericardiectomy who develop complications such as coronary artery fistulae may also be recommended for pericardiectomy to address the issue. Overall, the decision to recommend pericardiectomy for patients with coronary artery fistulae will depend on the individual patient’s symptoms, medical history, and overall health status.

Timeline

  • Before pericardiectomy: The patient may experience symptoms such as angina, dyspnea, or cardiac failure due to the presence of a giant coronary artery fistula.
  • Pericardiectomy: The surgical procedure to remove the pericardium, the membrane surrounding the heart, is performed to treat conditions such as constrictive pericarditis or cardiac tamponade.
  • After pericardiectomy: The patient undergoes percutaneous closure of the giant coronary artery fistula using a ductal occluder to relieve symptoms and improve cardiac function. This minimally invasive procedure helps to avoid the need for further surgery and can lead to a successful outcome for the patient.

What to Ask Your Doctor

  1. What is a pericardiectomy and why was it necessary for my condition?
  2. What are the potential risks and complications of a pericardiectomy procedure?
  3. How will a pericardiectomy affect my recovery and overall health?
  4. What symptoms should I watch for after the procedure that may indicate complications?
  5. How long will it take for me to fully recover from a pericardiectomy?
  6. Will I need any follow-up appointments or additional treatments after the procedure?
  7. Are there any lifestyle changes or medications I should consider after a pericardiectomy?
  8. How will the pericardiectomy affect my risk of developing complications such as coronary artery fistulae in the future?
  9. What are the treatment options for coronary artery fistulae and why was percutaneous closure recommended for me?
  10. What are the potential risks and benefits of percutaneous closure for a giant coronary artery fistulae?

Reference

Authors: Unzué L, García E, Díaz-Antón B, Fernández-Portales J, Teijeiro R, Rodríguez-Del-Río M. Journal: Cardiovasc Revasc Med. 2017 Jul-Aug;18(5):384-389. doi: 10.1016/j.carrev.2017.03.002. Epub 2017 Mar 9. PMID: 28320605