Angiographic and clinical manifestations of coronary fistulas in Chinese people - 15-year experience

Chiung Zuan Chiu, Kou Gi Shyu, Jun Jack Cheng, Shen Chang Lin, Shih Huang Lee, Huei Fong Hung, Jer Young Liou

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Background: Coronary artery fistula (CAF) is an anomaly resulting in the steal phenomenon of coronary blood flow, which may cause morbidity or mortality. CAFs in Chinese patients after long-term follow-up of 15 years were retrospectively analyzed. Methods and Results: From September, 1992 to August, 2007, 152 CAFs were detected in 28,210 coronary angiograms from 125 patients. Clinical and angiographic data of all patients were analyzed retrospectively. Two types of CAFs were characterized: type I in 99 patients with 124 solitary coronary to cardiac chamber or great vessel fistula; type II: 26 patients with 28 coronary artery - left ventricular multiple microfistulas. Single-, double-,and triple-CAFs were detected in 79%, 20%, and 1% of patients, respectively. Coexistent coronary lesions were noted in 41% of patients. Fistula-related symptoms included stable angina in 55, myocardial infarction in 2, heart failure in 2, sudden death with ventricular fibrillation in 1, and syncope in 1. Twenty-four patients had coexistent congenital anomalies. Only 9 patients underwent coronary intervention or/and surgery for CAFs. Conclusions: CAFs may cause trivial or lethal cardiac events, and may coexist with coronary lesion or congenital anomaly. Coronary to cardiac chamber or great vessel fistula and coronary-left ventricular multiple microfistulas have different morphologic and pathological phenomena.

Original languageEnglish
Pages (from-to)1242-1248
Number of pages7
JournalCirculation Journal
Issue number8
Publication statusPublished - 2008


  • Congenital anomaly
  • Coronary artery fistula
  • Coronary artery lesions
  • Heart failure
  • Myocardial ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology


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