Coronary artery–pulmonary artery fistula in pulmonary atresia with ventricular septal defect: report of two surgical cases

2021 ◽  
pp. 1-4
Author(s):  
Arif Yasin Çakmak ◽  
Ilker Kemal Yucel ◽  
Ahmet Sasmazel
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Septal Defect ◽  
Left Main Coronary Artery ◽  
Ductus Arteriosus ◽  
Pulmonary Atresia ◽  
Left Main ◽  
Aortopulmonary Collateral ◽  
The Right ◽  
Pulmonary Artery Fistula

Abstract Pulmonary atresia with ventricular septal defect is a complex congenital cardiac anomaly. The blood is supplied to the lungs through a patent ductus arteriosus, a major aortopulmonary collateral artery, or in very rare cases from a coronary artery–pulmonary artery fistula. We present two cases with coronary artery–pulmonary artery fistula which underwent surgical intervention. In our first patient, the main pulmonary artery was supplied from the left main coronary artery. In the second patient, the right pulmonary artery originated from the left main coronary artery and continued to the right lung posteriorly to the aorta, while the left pulmonary artery originated from the patent ductus arteriosus. The difference in our cases is that the coronary artery pulmonary artery fistulas behave like major aortopulmonary collateral arteries originating from the coronary arteries. These fistulas were the main source of pulmonary blood flow.

Utilisation of a three-dimensional printed model for the management of coronary-pulmonary artery fistula from left main coronary artery

2019 ◽  
Vol 29 (3) ◽  
pp. 431-434 ◽  
Author(s):  
Amrit Misra ◽  
Henry L. Walters ◽  
Daisuke Kobayashi
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Three Dimensional ◽  
Pulmonary Atresia ◽  
Left Main ◽  
Collateral Arteries ◽  
Collateral Artery ◽  
Aortopulmonary Collateral ◽  
Pulmonary Artery Fistula

AbstractCoronary-pulmonary artery fistula is a rare anomaly in which an aortopulmonary collateral artery arises from a coronary artery, often seen in patients with pulmonary atresia with ventricular septal defect. In the presented case, a coronary-pulmonary artery fistula arose from the left main coronary artery and supplied blood flow to a left upper lobe segment. The life-sized three-dimensional printed model was helpful in pre-surgical planning for unifocalisation of the aortopulmonary collateral arteries.

scholarly journals P1727 Large coronary artery to pulmonary artery fistula as primary source of pulmonary blood supply in tetralogy of fallot with pulmonary atresia

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Aslam ◽  
Z Rashid ◽  
M Mohsin ◽  
D Chowdhury ◽  
B Sultan Hasan
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Blood Supply ◽  
Left Main Coronary Artery ◽  
Pulmonary Atresia ◽  
Primary Source ◽  
Left Main ◽  
Grade 3 ◽  
Pulmonary Artery Fistula

Abstract Funding Acknowledgements Not Applicable OnBehalf Not Applicable Introduction Pulmonary blood supply in patients of Tetralogy of Fallot with pulmonary atresia is usually from patent arterial duct or major aortopulmonary collaterals (MAPCAs) arising from descending thoracic aorta. We describe a case in which large coronary to pulmonary artery fistula was the primary source of pulmonary blood supply. Case Report A 17 years old female was referred to our hospital for diagnostic workup of suspected congenital heart disease. She was previously undiagnosed and now complains of progressive shortness of breath for last few months. On physical examination she was non-dysmorphic with oxygen saturation of ∼ 77 % in room air, blood pressure of ∼ 117/72 mmHg, pulse rate of ∼ 89 beats per minute and respiratory rate of ∼ 24 breaths per minute. She was clinically cyanosed with grade 3 clubbing and polycythemic. Cardiovascular examination revealed quiet precordium with normally placed apex beat, grade 2 parasternal heave with single second heart sound and grade 3/6 continuous murmur along left mid sternal border. Twelve lead electrocardiogram (ECG) showed normal sinus rhythm, right axis deviation and right ventricular hypertrophy. There was no evidence of ischemia. Chest X-ray revealed "boat shaped heart" with oligaemic lung fields. Transthoracic echocardiography showed large conoventricular ventricular septal defect with bidirectional flow. There was aortic over-ride with dilated left main coronary artery. No forward flow was seen across right ventricular outflow tract. Considering hugely dilated left main coronary artery, suspicion of coronary to pulmonary artery fistula was made and cardiac computed tomography followed by conventional angiography was done, both confirmed the diagnosis of Tetralogy of Fallot with pulmonary atresia and large coronary artery to main pulmonary artery fistula as a primary pulmonary blood supply. Two small collaterals (MAPCAs) were also identified supplying small part of right and left lungs. Conclusion This case highlights unusual source of pulmonary blood supply in Tetralogy of Fallot with pulmonary atresia. Correct pre-operative diagnosis is essential for appropriate surgical planning and better outcome. Abstract P1727 Figure. TOF-PA with CA to PA Fistula

Ligation of a Fistula between the Left Main Coronary Artery and Both the Pulmonary Artery and the Right Ventricle

2012 ◽  
Vol 15 (2) ◽  
pp. 119 ◽  
Author(s):  
I. Halil Algin ◽  
Aytekin Yesilay ◽  
N. Murat Akcar
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Left Main Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Main ◽  
Symptomatic Disease ◽  
Coronary Artery Fistulas ◽  
The Right

The frequency of coronary artery fistula among all coronary angiography patients is 0.1% to 0.2%; however, involvement of both the pulmonary artery and the right ventricle is a rare clinical entity. A 53-year-old man patient was admitted to our clinic with rarely occurring chest pain, palpitations, and dyspnea. A coronary angiogram showed a fistula between the left main coronary artery and both the pulmonary artery and the right ventricle. We performed a ligation of this fistula without cardiopulmonary bypass. Aorta and right ventricle sutures were made, and the proximal and distal portions of the fistula were obliterated with 5-0 Prolene sutures and previously prepared Teflon felt. The patient recovered and was discharged without any complications. The surgical indications for coronary artery fistulas are symptomatic disease, an aneurysmic coronary artery, signs of heart failure, and ischemia. The surgical options in such cases�depending on whether the fistula is complicated or not�are simple ligation or transarterial ligation under cardiopulmonary bypass.

scholarly journals Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

2017 ◽  
Vol 5 (1) ◽  
pp. 232470961668462 ◽  
Author(s):  
Venkat Gangadharan ◽  
Kamesh Sivagnanam ◽  
Ghulam Murtaza ◽  
Michael Ponders ◽  
Otto Teixeira ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Main Pulmonary Artery ◽  
Shortness Of Breath ◽  
Left Heart ◽  
Coronary Angiogram ◽  
Left Main ◽  
Large Area ◽  
The Right

A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.

Left main coronary artery-to-pulmonary artery fistula with severe aneurysmal dilatation

2004 ◽  
Vol 77 (3) ◽  
pp. 1081-1083 ◽  
Author(s):  
Kimberly L Gandy ◽  
Abdallah G Rebeiz ◽  
Andrew Wang ◽  
James J Jaggers
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Aneurysmal Dilatation ◽  
Pulmonary Artery Fistula

Coronary Artery-to-Pulmonary Artery Fistula in a Case of Pulmonary Atresia With Ventricular Septal Defect

2011 ◽  
Vol 32 (7) ◽  
pp. 1017-1022 ◽  
Author(s):  
Shyam K. Sathanandam ◽  
Rohit S. Loomba ◽  
Michel N. Ilbawi ◽  
Andrew H. Van Bergen
Keyword(s):  
Coronary Artery ◽  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Septal Defect ◽  
Pulmonary Atresia ◽  
Pulmonary Artery Fistula

scholarly journals ANOMALOUS AORTIC ORIGIN OF THE LEFT MAIN CORONARY ARTERY ASSOCIATED WITH ARTERIAL COMPRESSION - CASE REPORT

2020 ◽  
Author(s):  
Davi Tenório ◽  
Leonardo Miana ◽  
Antonio Carlos de Almeida Barbosa Filho ◽  
Monica Gonzales Coronel ◽  
Gustavo Guerreiro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Left Main Coronary Artery ◽  
Postoperative Recovery ◽  
Shortness Of Breath ◽  
Left Main ◽  
External Compression ◽  
The Right

Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. We present a case of an 11-year-old female who presented with episodes of shortness of breath, angina and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. Patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with autologous pericardium and creation of neo-ostium in aorta. Patient had satisfactory postoperative recovery, was discharged on the fifth day post op, and remains asymptomatic after six months follow-up. Herein we present surgical video and postoperative echo and CT scan.

scholarly journals Incidentally Diagnosed Malignant Coronary Artery Anomaly: A Clinical Case

Medicina ◽  
2013 ◽  
Vol 49 (10) ◽  
pp. 72
Author(s):  
Domas Golubickas ◽  
Justina Motiejūnaitė ◽  
Antanas Jankauskas ◽  
Rimvydas Šlapikas ◽  
Algidas Basevičius
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Artery Anomalies ◽  
Heavy Exercise ◽  
Left Main ◽  
Investigation Methods ◽  
The Right ◽  
Congenital Coronary Artery Anomalies ◽  
Myocardial Hypoperfusion

The incidence of congenital coronary artery anomalies is estimated to range between 1% and 2% in the general population. The separate types of coronary artery anomalies are even rarer – the left main coronary artery arising from the right coronary sinus and passing between the thoracic aorta and the pulmonary artery is one of them. In this case, the segment of the artery that courses between the aorta and the pulmonary artery is prone to compression, especially during heavy exercise. Outcomes may be fatal due to myocardial hypoperfusion, which is associated with sudden cardiac death especially among children, young adults, and athletes. Nowadays, innate coronary artery anomalies may be incidentally diagnosed in older age using new investigation methods such as computed tomography angiography.

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