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Chapter 51. Percutaneous Treatment of Coronary Artery Fistula

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

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

B. A CAF may close and resolve spontaneously.

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

D. A and B.

E. All of the above.

The correct answer is E

All of the statements are correct.

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

A. Open surgical ligation with suture

B. Transcatheter coil embolization

C. Hyperbaric oxygen therapy

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

The correct answer is C

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.

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

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

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

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.

D. A and B.

E. A and C.

F. All of the above.

The correct answer is E

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.

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

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

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

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