Coronary Cameral Fistula Closure

Coronary-cameral fistulas (CCFs) are abnormal communications between coronary arteries and cardiac chambers. Predominant symptoms are angina and heart failure, although the majority are asymptomatic, particularly small CCFs. The therapeutic approach consists of a medical, surgical, or transcatheter approach. However, the optimal strategy is controversial and percutaneous transcatheter closure (TCC) is increasingly applied with promising results as an effective and safe alternative to surgery. In evaluating a patient with CCFs, the following parameters should be considered: Location (proximal vs distal), size (small vs large) and number of the CCFs (single vs multiples). Symptomatic patients with moderate or large size CCF should be discussed in the multidisciplinary team and carefully selected for TCC considering that myocardial infarction (MI) is a major complication of this procedure. In this section, we will discuss the role of cardiac imaging in diagnosis of CCFs and pre and post-procedural assessment of the patients who are candidate for TCC.