AGA's Amplatzer Devices Studied to Treat Congenital Cameral Fistulae

April 28, 2010—Elchanan Bruckheimer, MBBS, et al have concluded that transcatheter closure of coronary-cameral fistulae with Amplatzer devices (AGA Medical Corporation, Plymouth, MN) is safe and effective. The investigators published their findings in Catheterization and Cardiovascular Interventions (2010;75:850–854).

The background of the study is that large coronary-cameral fistulae cause a steal phenomenon from the normal coronary circulation. Surgical closure is an option; however, transcatheter methods allow for temporary occlusion, definition of anatomy, and online assessment of successful closure. The investigators noted that Amplatzer devices are compact occluders that can be fully delivered, collapsed, and repositioned until a satisfactory position is attained.

In the study, coronary and fistula anatomy were defined by selective coronary angiography with or without temporary occlusion. Device closure of the fistula was performed at the most distal point accessible, often from the cameral side using an arteriovenous loop method. Ten patients of median age 2.6 years (range, 0.5–52.2 y) and weight 14.4 kg (range, 6.1–67 kg) underwent an attempt at transcatheter closure of a large fistula. In nine patients, the fistula was closed successfully with a device. There were no complications, the investigators reported.