[Clinical application of AMPLATZER Vascular Plug Ⅱ in transcatheter closure of congenital coronary artery fistula in children].

OBJECTIVE: To evaluate the feasibility of applying AMPLATZER Vascular Plug Ⅱ (AVP Ⅱ) in transcatheter closure of congenital coronary artery fistula in children.

METHOD: Transcatheter closure procedure applying AVP Ⅱ was carried out in 7 patients (3 males and 4 females, age 1.2-12.0 years) with congenital coronary artery fistula between May 2014 and September 2015 in Pediatric Cardiology Department of Guangdong Cardiovascular Institute. Selective coronary artery angiography and aortic root angiography were performed after the release of the device to evaluate the immediate therapeutic effect. Echocardiography and electrocardiography were performed at 1 day, 1 month, 3 months, 6 months, 1 year post procedure and repeated once a year during the follow-up period.

RESULT: Transcatheter deployment of the device was successfully accomplished in all patients. The narrowest diameter of the fistula was (8.6±2.8) mm (4.0-12.5 mm), and the size of the deployed device ranged from 10.0 to 16.0 mm. Immediate selective coronary artery angiography revealed no residual shunt in 5 patients and trivial residual shunt in 2 patients. During a mean follow-up period of 2.7 (1.0-16.0) months, echocardiography showed that 3 patients remained no residual shunt, while 2 patients had trivial residual shunt, 2 patients developed small residual shunt. Cardiac murmur disappeared post procedure in all patients. Electrocardiography showed no ST-T changes. No migration or detachment of the device was found.

CONCLUSION: AVP Ⅱ is a safe and effective choice in transcatheter closure of congenital coronary artery fistula in children.