Advanced atrioventricular block and left bundle branch block in a patient with coronary artery fistula

2020 ◽  
Vol 13 (12) ◽  
pp. e238635
Author(s):  
Ryohei Ono ◽  
Sho Okada ◽  
Mari Kitagawa ◽  
Hiroyuki Takaoka ◽  
Hideyuki Miyauchi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Atrioventricular Block ◽  
Right Coronary Artery ◽  
Left Bundle Branch Block ◽  
Pacemaker Implantation ◽  
Coronary Artery Fistula ◽  
Ct Scans ◽  
Bundle Branch Block ◽  
Coronary Artery Fistulas

Coronary artery fistulas are abnormal vascular conduits, rarely related to atrioventricular conduction abnormalities. We report the case of a 52-year-old woman who presented with dyspnoea on exertion. Her ECG revealed advanced atrioventricular block and left bundle branch block. CT scans confirmed two fistulas, from the conus branch of right coronary artery and from the left anterior descending coronary artery, into the pulmonary artery. The patient underwent pacemaker implantation. To date, only nine patients with different degrees of heart blocks associated with coronary artery fistulas have been reported. Herein, we review and summarise previously reported cases of different degrees of heart blocks associated with coronary artery fistulas.

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 Transcatheter Coil Embolization of Single Coronary Artery Fistula Using the Occlusion Test

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Shin Takahashi ◽  
Yurie Takizawa ◽  
Satoshi Nakano ◽  
Junichi Koizumi ◽  
Kotaro Oyama
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coil Embolization ◽  
Coronary Artery Fistula ◽  
Single Coronary Artery ◽  
Total Occlusion ◽  
Occlusion Test ◽  
Embolization Treatment ◽  
Coronary Artery Fistulas ◽  
The Right

The case of a patient in whom hemodynamic and electrocardiographic studies using the occlusion test for coronary artery fistulas (CAF) were safely performed prior to catheter embolization is reported. A 1-year-old girl had a separate right coronary artery arising from a left single coronary artery that formed a significant coronary artery fistula to the right ventricle. Coronary steal by the large coronary artery fistula narrowed the left coronary artery. The right coronary artery branches could not be clearly identified due to an overlap with the fistula. Due to the long porous CAF, embolic procedures could cause serious complications. We confirmed the safety by performing an occlusion test of the CAF’s proximal blood vessels. Following total occlusion of the CAF for 10 minutes, pulmonary arterial pressure and aortic blood pressure were not significantly changed. No bradycardia, atrioventricular block, or ST changes were observed. Coil embolization treatment was performed safely. For patients with long distal CAF complicated with a single coronary artery, myocardial ischemia and conduction system disorders can be identified by performing the occlusion test before embolization.

scholarly journals Bilateral coronary artery - pulmonary artery fistula with recurrent ventricular tachycardia: Case report

2015 ◽  
Vol 143 (9-10) ◽  
pp. 609-614
Author(s):  
Anastazija Stojsic-Milosavljevic ◽  
Miroslav Bikicki ◽  
Vladimir Ivanovic ◽  
Nikola Sobot ◽  
Momcilov Popin ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Pulmonary Artery ◽  
Implantable Cardioverter Defibrillator ◽  
Right Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Hand ◽  
Cardioverter Defibrillator ◽  
Electrophysiology Study ◽  
The Right

Introduction. Bilateral coronary artery fistulae to pulmonary artery with ventricular tachycardia have not yet been described in the literature. Case Outline. A case of a 23-year-old male patient who was treated at our clinic for recurrent ventricular tachycardia is presented. The patient was born with six fingers on his left hand, which was surgically corrected in his early childhood. Perfusion scintigraphy demonstrated reversible ischemia at the irrigation zone of the right coronary artery. The coronary angiography revealed two coronary to pulmonary artery fistulae. The right coronary artery fistula drained through a tubular vessel formation into the pulmonary artery, but the left anterior descendent fistula drained via multiple thin tortuous vessels into the pulmonary artery. The right coronary artery fistula was ligated surgically. The control scintigraphy registered no perfusion defect subsequently, but during the procedure ventricular tachycardia occurred. An electrophysiology study followed, but ventricular tachycardia could not be provoked. Two months later ventricular tachycardia occurred again. Two subsequent electrophysiology studies showed no ventricular tachycardia. The patient was treated with an implantable cardioverter defibrillator. Ventricular tachycardia was terminated four times during the first year follow-up. Conclusion. The mechanism of the ventricular tachycardia was unclear. The electrophysiology study was not sufficiently reliable in the patient with recurrent ventricular tachycardia and bilateral coronary artery to pulmonary artery fistulae. The therapy of choice and the prevention of sudden death in this case was an implantable cardioverter defibrillator.

Intraoperative Transesophageal Echocardiography in the Management of a Right Coronary Artery to Coronary Sinus Fistula

2013 ◽  
Vol 1 (1) ◽  
pp. 21-23
Author(s):  
Stephen O Bader
Keyword(s):  
Coronary Artery ◽  
Transesophageal Echocardiography ◽  
Right Coronary Artery ◽  
Coronary Sinus ◽  
Coronary Artery Fistula ◽  
Intraoperative Transesophageal Echocardiography ◽  
Coronary Artery Fistulas

ABSTRACT Coronary artery fistulas are rare but can have significant perioperative consequences. We describe the case of a 65- year-old man found to have a coronary artery fistula from the anterior right coronary artery to the coronary sinus. We discuss the unique advantages that transesophageal echocardiography offers in the monitoring and management of coronary artery fistulas. How to cite this article McHugh SM, Bader SO. Intraoperative Transesophageal Echocardiography in the Management of a Right Coronary Artery to Coronary Sinus Fistula. J Perioper Echocardiogr 2013;1(1):21-23.

Right Coronary Artery Fistula Draining into the Right Atrium and Associated with Mitral Valve Stenosis: A Case Report

2007 ◽  
Vol 10 (4) ◽  
pp. E325-E328 ◽  
Author(s):  
Ali Gürbüz ◽  
Ufuk Yetkin ◽  
Ömer Tetik ◽  
Mert Kestelli ◽  
Murat Yesil
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Right Coronary Artery ◽  
Right Atrium ◽  
Coronary Artery Fistula ◽  
Mitral Valve Stenosis ◽  
The Right

A Giant Right Coronary Artery of Diffuse Ectasia Induced by a Right Ventricular Fistula

2015 ◽  
Vol 18 (6) ◽  
pp. 253
Author(s):  
Renyuan Li ◽  
Yiming Ni ◽  
Peng Teng ◽  
Weidong Li
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Artery Bypass ◽  
Coronary Artery Fistula ◽  
Rare Entity ◽  
Fistula Closure ◽  
Unique Case ◽  
Coronary Ectasia ◽  
The Right ◽  
Giant Size

<p>Coronary artery fistula (CAF) is a rare entity. Sometimes it may associate with mild diffuse or segmental coronary ectasia. CAF with giant coronary artery is exceptionally rare. We present a unique case of a 49-year-old female patient with a giant right coronary artery of diffuse ectasia coexisting with a fistula draining into the right ventricle. To our best knowledge, CAF with diffuse coronary ectasia of such giant size has never been reported. The patient was treated successfully by resection of the dilated right coronary artery, fistula closure, and coronary artery bypass grafting.</p>

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