{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:41:40Z","timestamp":1769172100318,"version":"3.49.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Residual shunts after tetralogy of Fallot (TOF) repair are rare and can stem from residual defects, unrecognized VSDs, or, rarely, acquired coronary cameral fistulas (CCFs). Correctly distinguishing these is vital since treatments differ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>Two paediatric cases following TOF repair are described: one shows features of an acquired CCF with continuous flow from the coronary artery into the right ventricle. Because of the low shunt fraction, asymptomatic presentation, and lack of guidelines for definitive treatment, the patient is managed conservatively with regular monitoring. The other case, though asymptomatic, demonstrates a significant residual VSD with holosystolic flow; increased pulmonary blood flow and a significant shunt on cardiac catheterization indicate the need for catheter closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Acquired CCF is a rare, usually asymptomatic complication managed conservatively, while residual VSDs may cause significant haemodynamic issues requiring intervention. Echocardiography, assessing flow timing, jet origin, and haemodynamics, is key for differentiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf675","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T12:34:42Z","timestamp":1768653282000},"source":"Crossref","is-referenced-by-count":0,"title":["Residual shunts after tetralogy of Fallot repair: two case illustrations and echocardiographic insights"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8186-8794","authenticated-orcid":false,"given":"Sedhupathi","family":"Shanmugam","sequence":"first","affiliation":[{"name":"Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala 695011 ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"2026012112085595900_ytaf675-B1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ijcard.2004.09.005","article-title":"Acquired coronary artery fistula after open heart surgery for congenital heart disease","volume":"103","author":"Chiu","year":"2005","journal-title":"Int J Cardiol"},{"key":"2026012112085595900_ytaf675-B2","first-page":"1","article-title":"Coronary arteriovenous fistulae: a review","volume":"23","author":"Challoumas","year":"2014","journal-title":"Int J Angiol"},{"key":"2026012112085595900_ytaf675-B3","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1111\/echo.15399","article-title":"Diagnosis of left anterior descending branch-right ventricular fistula with giant coronary artery aneurysm by contrast echocardiography: a case report","volume":"39","author":"Li","year":"2022","journal-title":"Echocardiogr"},{"key":"2026012112085595900_ytaf675-B4","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.circv.2021.04.003","article-title":"Postsurgical coronary artery fistula after tetralogy of fallot repair","volume":"28","author":"Fernandez-Ruiz","year":"2021","journal-title":"Cirug\u00eda Cardiovascular"},{"key":"2026012112085595900_ytaf675-B5","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s12055-006-0503-2","article-title":"Iatrogenic coronary-cameral fistula following intracardiac repair of tetralogy of fallot: case report","volume":"22","author":"Kale","year":"2006","journal-title":"Indian J Thorac Cardiovasc Surg"},{"key":"2026012112085595900_ytaf675-B6","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S0002-9149(99)80568-2","article-title":"Acquired coronary artery fistulae after right ventricular myotomy and\/or myomectomy for congenital heart disease","volume":"75","author":"Urcelay","year":"1995","journal-title":"Am J Cardiol"},{"key":"2026012112085595900_ytaf675-B7","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.athoracsur.2012.05.091","article-title":"Double-barrel right ventricular outflow: tetralogy of Fallot annulus preservation technique","volume":"94","author":"Reyes","year":"2012","journal-title":"Ann Thorac Surg"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/1\/ytaf675\/66519072\/ytaf675.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/1\/ytaf675\/66519072\/ytaf675.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T17:09:04Z","timestamp":1769015344000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf675\/8435653"}},"subtitle":[],"editor":[{"given":"Constantin","family":"K\u00fchl","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Christoph","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf675","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2026,1]]},"article-number":"ytaf675"}}