scholarly journals 996 Non ST Elevation Myocardial Infarction (NSTEMI) And Complex Coronary Artery Fistula In A Fit 57 Year Old Man And Its Management

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M I K Malik
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Main Pulmonary Artery ◽  
Coronary Artery Fistula ◽  
Stent Insertion ◽  
Rare Finding ◽  
Wave Inversion ◽  
Obtuse Marginal

Abstract A fit 57-year-old man presented with exertional chest pain to the emergency department and was found to have anterolateral T wave inversion on ECG and blood troponin of 1290. Coronary angiography showed a severe proximal to mid-course lesion in the mid left anterior descending artery (LAD), severe ostial disease in obtuse marginal 1 (OM1) and large a coronary artery fistula (CAF) between the proximal LAD and main pulmonary artery (PA). Subsequent cardiac computer tomography multiple gated acquisition (CT MUGA) scan showed a coronary artery to main PA fistula, fed by small branches of the LAD and right coronary artery (RCA). Cardiac magnetic resonance (CMR) showed preserved left ventricle systolic function, ejection fraction 62%, and small left to right shunt. Following multidisciplinary discussion, the consensus was to offer coronary artery bypass grafting (CABG) and fistula ligation as the first option, but percutaneous intervention (PCI) to the LAD would also be feasible. After lengthy discussions, the patient declined CABG and opted for PCI and stent insertion. CAF on angiogram is a rare finding, CAF is an abnormal connection between a coronary artery and either a cardiac chamber or a great vessel including the pulmonary artery. This case highlights a rare finding and its subsequent investigative workup and management considerations.

Non-ST elevation myocardial infarction (NSTEMI) and complex coronary artery fistula in a fit 57-year-old man and its management

2021 ◽  
Vol 14 (2) ◽  
pp. e237321
Author(s):  
Muhamamd Isfandyar Khan Malik
Keyword(s):  
Coronary Artery ◽  
Systolic Function ◽  
Artery Bypass ◽  
Main Pulmonary Artery ◽  
Coronary Artery Fistula ◽  
Stent Insertion ◽  
Wave Inversion ◽  
Gated Acquisition ◽  
St Elevation ◽  
Obtuse Marginal

A fit 57-year-old man presented with exertional chest pain to the emergency department and was found to have anterolateral T wave inversion on ECG and blood troponin of 1290. Coronary angiography showed a severe proximal to mid-course lesion in mid left anterior descending (LAD) artery, severe ostial disease in obtuse marginal 1 (OM1) and large coronary artery fistula between proximal LAD and main pulmonary artery (PA). Subsequent cardiac CT multiple gated acquisition scan showed a coronary artery to main PA fistula, fed by small branches of the LAD and right coronary artery (RCA). Cardiac magnetic resonance (CMR) showed preserved left ventricle systolic function, ejection fraction 62% and small left to right shunt. Following multidisciplinary team (MDT) discussion, the patient was offered coronary artery bypass grafting (CABG) and fistula ligation as first option, but percutaneous intervention (PCI) to the LAD would also be feasible. After lengthy discussions the patient declined CABG and opted for PCI and stent insertion.

scholarly journals Successful Surgical Treatment of Giant Coronary Artery Aneurysm and Concomitant Coronary Artery Fistula to the Pulmonary Artery

2018 ◽  
Vol 21 (4) ◽  
pp. E247-E249
Author(s):  
Keito Suzuki ◽  
Naoyuki Kimura ◽  
Akira Sezai ◽  
Satoshi Unosawa ◽  
Makoto Taoka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Bypass ◽  
Artery Aneurysm ◽  
Coronary Artery Fistula ◽  
Fistula Formation ◽  
Bypass Grafting ◽  
Postoperative Course ◽  
Giant Coronary Artery Aneurysm

Giant coronary artery aneurysm (GCAA) combined with coronary artery fistula to the pulmonary artery (PA) is rare. A 79-year-old man was accidentally discovered with GCAA. He was operated on by use of aneurysmorrhaphy, and closure of the fistulae was performed. Because ischemic changes appeared, coronary artery bypass grafting was done. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. We report here a case of GCAA with a size of 66 × 52 mm in diameter associated with a fistula formation into the PA. It is one of the largest sizes of GCAA that has occurred after fistula formation.

scholarly journals Successful repair of an anomalous right coronary artery arising from the pulmonary artery in a 10 month-old

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Matthew C Schwartz ◽  
◽  
William Hammill ◽  
Thomas S Maxey ◽  
◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Coronary Artery ◽  
Systolic Function ◽  
Main Pulmonary Artery ◽  
Left Ventricular Systolic Function ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Normal Left Ventricular ◽  
Collateral Network

Echocardiogram (Figure 1A-B) in an asymptomatic 6 month-old raised suspicion for anomalous Right Coronary Artery (RCA) from the Pulmonary Artery (ARCAPA) with retrograde flow from the RCA to the main pulmonary artery. The patient’s left ventricular systolic function was normal. Subsequent cardiac catheterization confirmed the diagnosis as angiography showed that the RCA arose from the anterior aspect of the main pulmonary artery and filled retrograde via a collateral network from the Left Coronary Artery (LCA) system (Figure 1C-D). At 10 months of age, the patient underwent surgical translocation of the RCA to the aorta. On direct visualization, the RCA arose from the anterior wall of the main pulmonary artery and the robust collateral supply of the RCA from the LCA was visualized on the heart’s epicardium (Figure 2). The patient did well and was discharged home several days later. Three months after the operation, the patient continues to do well with normal left ventricular systolic flow and prograde flow into the reimplanted RCA.

Dual-source CT in Diagnosis of Coronary Artery Fistula and its Value

2020 ◽  
Author(s):  
Cheng WANG ◽  
Yaying LI ◽  
Jiangyong LIU
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Correct Diagnosis ◽  
Main Pulmonary Artery ◽  
Image Data ◽  
Coronary Artery Fistula ◽  
Coronary Fistula ◽  
Detection And Diagnosis ◽  
The Right ◽  
Pulmonary Artery Fistula

Abstract Background: Coronary artery fistula refers to the symptom that the coronary artery trunk or branch connects with the heart cavity or the pulmonary circulation blood vessels in a congenital or an acquired manner. As early detection and diagnosis of CAF was necessary for the prevention and management of late symptoms and complications, we are supposed to master the imaging performance of CAFs so as to make a correct diagnosis. This paper seeks to investigate the imaging manifestations and application value of CT diagnosis of coronary fistula and its application value. Methods: To retrospectively analyze the clinical data and DSCT image data of 62 patients with coronary fistula, and summarize, analyze and summarize their image manifestations and types.Results: 62 CAFs originate from 58 LCA vessels, 32 RCA vessels. The distribution frequency of drainage site from high to low was as follows: 40 cases (63%) of the main pulmonary artery, 10 cases (16%) of the right atrium, 7 cases (11%) of the right ventricle, 3 cases (5%) of the left ventricle, 1 case (2%) of the left atrium, and 1 case of coronary sinus (2%), 1 case of the right lower pulmonary vein (2%). There were 39 cases (63%) of single fistula vessel, and 23 cases (37%) of multiple fistula vessel, including 21 cases of left and right coronary arteries. Coronary artery-pulmonary fistulae were the most common with a total of 40 cases. Conclusion: The popularization of CT improved the detection rate of CAFs. Coronary pulmonary-artery fistula was probably the most common seen type of CAFs. ECG-gating coronary artery CTA can accurately assess the origin of CAFs, the course of fistula vessels, and the drainage site, thereby providing important information for clinicians to treat coronary fistula.Trial registration: retrospectively registered

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Detected by Echocardiography in an Asymptomatic Young Athlete

2016 ◽  
Vol 19 (6) ◽  
pp. 259
Author(s):  
Tolga Demir ◽  
Mehmet Umit Ergenoglu ◽  
Ali Kubilay Korkut ◽  
Nursen Tanrikulu ◽  
Ergun Demirsoy
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Artery Bypass ◽  
Main Pulmonary Artery ◽  
Young Athlete ◽  
Anomalous Origin ◽  
First Year ◽  
Surgical Closure ◽  
Echocardiographic Examination ◽  
First Year Of Life

The anomalous origin of the coronary artery from the pulmonary artery (ALCAPA) is the most common congenital coronary artery anomaly. Up to 90% of patients die during the first year of life. It is unusual for an ALCAPA patient to survive to adulthood. We present a case of an asymptomatic young athlete with ALCAPA, in which the diagnosis was established by echocardiography during pre-participation physical evaluation. The patient underwent surgical closure of the left main coronary artery ostium through the inside of the main pulmonary artery and coronary artery bypass grafting. He was discharged after 6 days and remained well during follow-up visits. We emphasize the importance of echocardiographic examination during pre-participation cardiovascular screening in young athletic populations to avoid sudden death related to ALCAPA.

scholarly journals Case of rheumatic mitral stenosis with bilateral coronary artery fistula to pulmonary artery: A rare entity

2021 ◽  
Vol 13 (2) ◽  
pp. 176-178
Author(s):  
Manish Jawarkar ◽  
Pratik Manek ◽  
Mausam Shah ◽  
Vivek Wadhawa ◽  
Chirag Doshi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Mitral Valve ◽  
Pulmonary Artery ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Stenosis ◽  
Main Pulmonary Artery ◽  
Coronary Artery Fistula ◽  
Post Operative Period ◽  
Pulmonary Artery Fistula

Coronary to pulmonary artery fistula is a rare form of congenital coronary artery anomaly. Majority of coronary arteriovenous fistula detected incidentally on coronary angiography. Although, most of these patients are asymptomatic, larger fistulae can produce symptoms of heart failure. Here we present a rare case of 61-year-old female who presented primarily for mitral valve replacement for severe mitral stenosis. On screening angiography, there were two fistula arising from both right and left coronary artery and draining in to the main pulmonary artery. The patient was operated and mitral valve replacement with closure of the fistula. Patient had an uneventful post-operative period and was discharged on 7 the post-operative day.

scholarly journals Preoperative Assessment of Anomalous Right Coronary Artery Arising from the Main Pulmonary Artery

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Marshall W. Winner ◽  
Subha V. Raman ◽  
Benjamin C. Sun ◽  
Juan A. Crestanello
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Right Coronary Artery ◽  
Artery Bypass ◽  
Main Pulmonary Artery ◽  
Rare Condition ◽  
Preoperative Assessment ◽  
Anomalous Coronary Artery ◽  
The Right ◽  
Anomalous Coronary

Anomalous origin of the right coronary artery from the pulmonary artery is a rare condition. Two cases are presented in this paper. One case was treated by ligation and coronary artery bypass. The other was treated by direct reimplantation of the anomalous coronary artery into the aorta.

Sign in / Sign up

Export Citation Format

Share Document