Occlusion of a Coronary Artery Fistula Using Amplatzer Vascular Plug II in a 1-Year-Old Girl—Secondary Publication

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We report the first case of catheter closure using Amplatzer vascular plug device for the coronary artery fistula (CAF); draining from the right coronary artery (RCA) into the left ventricle (LV), quite rare pattern among (CAF). A 1-year old girl had a giant right coronary artery-left ventricular fistula. The angiographic computed tomography of coronary artery and the catheter examination showed a dilated RCA from the orifice, feeding the original coronary arteryʼs region and drained into the LV. Catheter treatment was judged as possible from its anatomy. We inserted a guide wire from the right femoral artery (FA) to RCA-LV-aorta, and grabbed it out with a snare catheter from the left FA to make a loop of guide wire. Occlusion tests were performed repeatedly using balloon to avoid ischemia. The optimal device position was selected cautiously and was detached. A few cases of catheter device closure of CAF had been reported in infancy. Because of its technical advance, the transcatheter closure of CAF has low mortality rate, shows rapid recovery, and can be an alternative option to surgical treatment in infant cases.