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Chapter 51. Percutaneous Treatment of Coronary Artery Fistula

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Which of the following statements regarding coronary artery fistulae (CAF) is true?

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A. A coronary-cameral fistula is a type of CAF between a coronary artery and a chamber of the heart.

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B. A CAF may close and resolve spontaneously.

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C. Most CAFs are small and do not cause any symptoms or complications.

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D. A and B.

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E. All of the above.

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The correct answer is E

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All of the statements are correct.

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All of the following techniques are currently used to treat CAF except:

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A. Open surgical ligation with suture

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B. Transcatheter coil embolization

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C. Hyperbaric oxygen therapy

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D. Transcatheter placement of patent ductus arteriosus, atrial septal defect, or ventricular septal defect occluder devices

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The correct answer is C

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Hyperbaric oxygen therapy has no effect on CAF and is not recognized as a standard treatment. The other techniques are commonly performed in clinical practice for treatment of CAF.

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Which of the following statements is true regarding CAF and children?

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A. Children with CAF usually show no symptoms other than a heart murmur.

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B. The size and significance of a CAF cannot usually be determined by echocardiography.

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C. After diagnosis, closure of the CAF is often performed because of the danger of complications, such as rupture of the fistula, myocardial ischemia, or endocarditis.

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D. A and B.

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E. A and C.

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F. All of the above.

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The correct answer is E

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Echocardiography is often used to determine the size and importance of CAF. Typical echocardiographic features that indicate a significant CAF include cardiac chamber dilation, narrowest color Doppler flow jet ≥4 mm, or reversal of flow in the descending aorta. Both answers A and C are correct.

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All of the following statements regarding CAF and concerns about exercise are true except:

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A. There are no exercise restrictions for patients with small CAF with negligible symptoms.

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B. Patients with CAF are at a slightly higher than ...

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