_{Purpose: To evaluate the feasibility and effectiveness of transcatheter closure of large coronary artery fistula with shape-memory alloy occluder.
Method: Nine patients (aged 20±9.9 years, 2 males) with large coronary artery fistula were enrolled for percutaneous transcatheter closure using shape-memory alloy occluders (Cardi-O-Fix Occluder System, Starway Medical Technology Inc, Beijing, China), including 4 patients with right coronary artery to right ventricle fistula, 2 with left anterior descending coronary artery to right ventricle, 1 with left circumflex coronary artery to right ventricle, 1 with left circumflex coronary artery to right atrium and 1 with right coronary artery to left ventricle. The narrowest diameter of fistulas was 7±3.9mm (3.3-15mm) while the widest diameter 23±8.8mm (13-38mm) by coronary angiogram.
Result: The procedure was successful in 7 patients, of whom 6 patients received patent ductus arteriosus occluder (sized 10-20mm) while 1 received a 16mm muscular ventricular septal defect occluder plus 10 coils (sized 5-10mm). Angiogram immediately after the procedure demonstrated a complete occlusion in 6 patients and a small residual shunt in 1 patient which was not detected by echocardiography at 4 days after the procedure. The retrograde passing of delivery sheath was failed in the other 2 patients who were subsequently corrected by surgical technique. All the 9 patients survived during the follow-up of 1-6 months without notable symptoms.
Conclusion: Transcatheter closure of large coronary artery fistula with shape-memory alloy occluder is an effective, safe and reliable method.
Keywords: coronary artery fistula, transcatheter closure, shape-memory alloy occluder}