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Author Notes:

Joshua M. Rosenblum, MD, PhD, 1405 Clifton Rd NE, Atlanta, GA 30322. joshua.rosenblum@choa.org

Disclosures: Dr Chai is a consultant for Edwards and Dr Bauser-Heaton is a proctor for Gore. All other authors reported no conflicts of interest.


Journal Title:

JTCVS Techniques


Volume 17


, Pages 155-158

Type of Work:

Article | Final Publisher PDF


Coronary artery fistulas (CAFs) are exceedingly rare.1 They are defined as an abnormal communication between a coronary artery and another cardiac structure or major thoracic vessel. While largely presumed to be asymptomatic, a recent study showed that a majority of neonates/infants presented with heart failure–type symptoms, albeit many of them had a larger fistula size.2 Indications for intervention on CAFs have been controversial because many patients are asymptomatic; however, delaying intervention is associated with a significantly greater risk of death preoperatively and an increased risk of morbidity and mortality postoperatively.3 Therefore, the majority of CAFs are addressed when they are identified. Transcatheter and surgical approaches have been both been used with good success rates; however, the number of neonates undergoing repair by either method remains low.2,4 Here, we present a case of surgical repair of a large CAF in a neonate after an attempted transcatheter closure resulted in iatrogenic tricuspid regurgitation (TR). The institutional review board of Children's Healthcare of Atlanta approved the study protocol and publication of data (approval number: STUDY00001462, date approved: July 18, 2022). Patient written consent for the publication of the study data was waived by the institutional review board, as it was determined to be research not involving human subjects.

Copyright information:

© 2022 The Author(s)

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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