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Background: Most children with coronary artery fistulae are asymptomatic, but because of associated late morbidity, early intervention is usually indicated. Aim: To assess the outcome following transcatheter embolisation of coronary artery fistulae. Patients and Methods: Six children, with a median age of 9.5 years (range: 1.3–13.7 years), underwent transcatheter embolisation of coronary artery fistulae. Four patients had simple fistulae, which drained from the right coronary artery to the right ventricle (n = 2), the left coronary artery to the right ventricle (n = 1), or the left coronary artery to the coronary sinus (n = 1). Two patients had complex multiple fistulae arising from both coronary arteries, which communicated with either the right ventricle or the pulmonary arterial system. Results: A stable position with a 5-Fr coronary catheter was obtained proximally and a 3-Fr coaxial catheter was advanced through the coronary catheter to a distal position in the coronary artery fistulae. The number of embolisation microcoils used per procedure ranged from one to 12, and the coil diameter ranged from 3 mm. Polyvinyl alcohol foam embolisation particles (1000 μm) were used to embolise small fistulae to the pulmonary arterial tree. Complete occlusion was obtained in four patients, while two children were left with insignificant residual shunts. There were no early or late cardiac complications. Conclusion: Transcatheter embolisation of coronary artery fistulae is a safe and effective therapy in patients with suitable anatomy. (Heart, Lung and Circulation 2001; 10: 53–57). [ABSTRACT FROM AUTHOR]

A 51 year-old Aboriginal woman was diagnosed with H1N1 influenza virus and methicillin-resistant Staphylococcus aureus. Contrasted CT of the pulmonary and bronchial vasculature undertaken for investigation for of haemoptysis revealed an 11mm left upper lobe pulmonary artery pseudoaneurysm (PAP). The PAP was successfully treated with angioembolisation of the parent artery with two platinum coils. Pulmonary artery pseudoaneurysms are uncommon but potentially life-threatening and have not previously been reported in association with H1N1 influenza viral pneumonia, which has been prominent in recent times in both medical literature and popular press. [ABSTRACT FROM AUTHOR]

A young woman had symptoms from stenosis of the superior caval vein 8 years after surgical repair of sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage. She was successfully treated by balloon dilatation and stenting. [Copyright &y& Elsevier]

Background: Gated Blood Pool Imaging (GBPI) has low inter-test variability compared to echocardiography, and is often used when accurate repeated measurements of left ventricular ejection fraction are required such as in the surveillance of post-transplant patients. The aim of this study was to determine if cardiac MRI (CMR) could replace Gated Blood Pool Imaging for annual assessment of left ventricular (LV) function in the surveillance of patients post-cardiac transplantation. Methods: Forty-nine patients at various stages of post-cardiac transplantation presenting for annual review underwent LV functional assessment with GBPI and CMR. LV ejection fractions (EF) obtained from the two methods were compared and limits of agreement determined. Results: The mean EF (plus and minus two standard deviations) was 58.3±18% for GBPI and 57.6±18% for CMR. The two methods were found to provide clinically equivalent results. Conclusions: Assessment of LVEF with CMR offers comparable values to GBPI in post-heart transplant patients. However, CMR also allows quantitative volumetric analysis of ventricular volumes and assessment of wall motion and valvular function. As is now accepted in native heart assessment, CMR should be considered the “gold standard” for post-transplant volumetric and functional evaluation. CMR offers information over-and-above traditional imaging modalities. [Copyright &y& Elsevier]