Comparison of Pre- and Postnatally Diagnosed Coronary Artery Fistulae: Echocardiographic Features and Clinical Outcomes

Andrea Pisesky, MBBS, Lynne E. Nield, MD, Joanna Rosenthal, MD, Edgar T. Jaeggi, MD, and Lisa K. Hornberger, MD, Toronto, Ontario, Canada; and Edmonton, Alberta, Canada

Coronary artery fistulae (CAFs) are abnormal connections of a coronary artery to a cardiac chamber or vessel. There is a paucity of data regarding clinical outcomes, especially when detected prenatally. This was a multicenter retrospective cohort study of all CAF cases from 2002 to 2016. Clinical characteristics and outcomes were compared between the prenatal and postnatal cohorts. A scoping literature review of prenatal CAFs was completed.

Accreditation Statement:

The American Society of Echocardiography is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Echocardiography designates this activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program, the American Board of Pediatrics (ABP) MOC program, and/or the American Board of Anesthesiology’s (ABA) Maintenance of Certification in Anesthesiology Program® or MOCA 2.0®. It is ASE’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM and ABP MOC points and/or ABA MOCA 2.0®.   Physicians will earn MOC and/or MOCA 2.0 points equivalent to the amount of CME credits claimed for the activity.

ARDMS, CCI, and Sonography Canada recognize ASE’s certificates and have agreed to honor the CME credit hours toward their registry requirements for sonographers.

• Release Date: December 01, 2022
• Expiration Date: December 01, 2023 - CME/MOC must be claimed by this date.

Learning Objectives

At the end of this activity the reader will better be able to

1. 1. Define the incidence of CAF relative to all coronary artery anomalies, and common associated lesions;
   2. Recognize the most common sites of origin and exits of CAF;
   3. Use echocardiography to monitor prenatal CAF for both regression and progression;
   4. Appreciate the dilemmas in diagnosis and management of CAF; and
   5. Consider risks and benefits of either surgical or percutaneous interventions

Disclosure

ASE is committed to ensuring that its educational mission, and all accredited continuing educational programs provide a protected space to learn, teach, and engage in scientific discourse free from influence from organizations that may have an incentive to insert commercial bias into education.

While a monetary or professional affiliation with an ineligible company does not necessarily influence a speaker’s presentation, the Standards for Integrity and Independence in Accredited Continuing Education and policies of the ACCME require that all financial relationships with ineligible companies* be identified and mitigated prior to engaging in an accredited CE activity. In accordance with these policies, ASE actively identified relevant financial relationships between faculty in control of this accredited CE activity and ineligible companies and implemented mitigation strategies to eliminate any potential influence from persons or organizations that may have an incentive to insert commercial bias in this activity. (*Companies that are ineligible to be accredited in the ACCME System (“ineligible companies”) are those whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.)

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