Sometimes children are born with an abnormal placement of the arteries that supply the heart with blood, the coronary arteries. Additionally, abnormal branches from the coronary arteries, or fistulas, may be present.
Coronary arteries arising from an abnormal place may require surgical re-implantation or bypass. However, not all anomalous coronary arteries require surgery if the treating physician feels that the blood flow to the heart is not at risk. Often, it can be very difficult to determine the overall risk of sudden death in a patient with anomalous coronary arteries.
Many coronary artery fistulas may spontaneously go away over time. Large coronary artery fistulas may be occluded (blocked off) in a hospital’s catheterization lab using a thin tube (called a catheter) to place special metallic coils or devices to fill the abnormal vessel. Alternately, coronary artery fistulas may require surgical ligation (closure).
If the heart has sustained severe damage, cardiac transplantation may be the only treatment option.