Coronary-cameral fistulas in adults: Acquired types (second of two parts)

Table 1 Fistula characteristics in congenital and acquired coronary cameral fistulas of 243 reviewed subjects

Congenital CCFs n =159 (65%)			Acquired n = 84 (35%)
Solitary CCFs and coronary artery-ventricular multiple micro-fistulas[1]			Traumatic CCFs n =72 (85.7%)					Spontaneous n =12 (14.3%)
Sub-classification	Solitary 85%	MMFs 15%	Iatrogenic CCFs n =65/72 (90%)				Accidental CCFs n =7/72 (10%)
Aetiology	Congenital 65%		Post-SM	After other cardiac surgery	Post-EMB	EP and PCI	Blunt or sharp chest trauma	post-MI or associated with severe coronary artery disease
Female percentage	50%	63%	Unknown	20%	22%	33%	0%	0%
Mean age	46.2 (18-85)	62.7 (39-85)	45 (32-74)	61 (40-78)	50.8 (43-64)	60.8 (46-75)	24.1 (17-38)	61 (29-75)
Prevalence/incidence	135/159 (85%)	24/159 (15%)	20/65 (31%)	5/65 (8%)	25/65 (38%)	15/65 (23%)	10%	14.30%
Management	CMM 22%, SL 56%, PTE 22%	CMM 100%, incidentally ICD	CMM 11%, PTE 11%	WW 40%, CMM 40%, PTE 20%	CMM 73%	CMM	Surgical repair 100%	CMM 17%,
								SL 58%
Fistula characteristics
Origin
	Proximal segment Any cardiac chambers	Mid- or distal segment LV > RV	Septal perforators	LCA or RCA	RCA > LAD > Cx	LCA	RCA or LAD	RCA or LAD
Termination				Any cardiac chambers
			LV		RV	Any cardiac chambers	RV or LV	RV or LV
Spontaneous resolution	Occasionally	Not reported	High rate	Not reported	High rate	Occasionally	Not reported	8%

CCFs: Coronary cameral fistulas; CMM: Conservative medical management; EMB: Endomyocardial biopsy; EP: Electrophysiological procedures; ICD: Implantable cardioverter-defibrillator; LA: Left atrium; LAD: Left anterior descending artery; LCA: Left coronary artery; LV: Left ventricle; MI: Myocardial infarction; MMFs: Coronary artery-ventricular multiple micro-fistulas; PCI: Percutaneous coronary intervention; PTE: Percutaneous therapeutic embolization; RA: Right atrium; RCA: Right coronary artery; RV: Right ventricle; SL: Surgical ligation; SM: Septal myectomy; WW: Watchful waiting follow-up.