Depending on size of fistula and symptoms of the child, we can plan further management of these types of fistulas.
If child is having symptoms of heart failure likes difficulty in breathing etc, then it needs to be closed.
Now a day, coronary fistula can be closed in cath lab by using either vascular plug or ductal occluder (device technique).
Procedure
For using this method, we take blood vessels in leg and then we enter into the heart with the help of tubes and wires. Then we define the fistula by doing angiograms into the coronaries.
After defining the fistula where it is draining and what is the size of it, we select the appropriate device and then with the help of device cable, we deploy the device across the fistula.
Repeat angiograms done for seeing any residual across the device as well for confirming the correct position of the device.
After confirming the position of the device, device released by unscrewing the cable. Tab aspirin needs to be taken for 6 months.