scholarly journals Multiple Small Coronary Artery Fistulas Emptying into the Left Ventricle: A Rare but Challenging Problem

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Omar Kahaly ◽  
Konstantinos Dean Boudoulas
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Coronary Artery Fistula ◽  
Coronary Arteriography ◽  
Great Vessel ◽  
Challenging Problem ◽  
Atypical Chest Pain ◽  
Coronary Artery Fistulas ◽  
Appropriate Therapy ◽  
The Right

A coronary artery fistula (CAF) is an abnormal communication between a coronary artery and a cardiac chamber or a great vessel. CAFs are rare based on coronary arteriography and when found they most often empty into the right ventricle and atrium and less often into the high pressure, low compliance left ventricle (LV). A patient who presented with atypical chest pain and was found to have multiple small CAFs originating from the ramus intermedius coronary artery and emptying into the LV is presented. This case highlights the challenges in providing an appropriate therapy for multiple small CAFs emptying into the LV.

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.

Prenatal diagnosis of isolated coronary artery fistulas: progression and outcome in five cases

2015 ◽  
Vol 26 (5) ◽  
pp. 915-920 ◽  
Author(s):  
Gurleen K. Sharland ◽  
Laura Konta ◽  
Shakeel A. Qureshi
Keyword(s):  
Coronary Artery ◽  
Cardiac Failure ◽  
Transcatheter Closure ◽  
Coronary Artery Fistula ◽  
Congestive Cardiac Failure ◽  
Fetal Life ◽  
Circumflex Coronary Artery ◽  
Coronary Artery Fistulas ◽  
The Right

AbstractObjectivesThe aim of this study was to describe the clinical characteristics, progression, treatment, and outcomes in isolated coronary artery fistula cases diagnosed prenatally.MethodsWe carried out a retrospective review of babies diagnosed prenatally with coronary artery fistulas between January, 2000 and December, 2013; five fetuses were included. Echocardiographic features and measurements were noted during pregnancy and after birth. Treatment and outcome were noted.ResultsGestational age at initial diagnosis was between 19 and 22 weeks; four coronary artery fistulas originated from the right and one from the left circumflex coronary artery. Drainage was into the right atrium in four cases and into the left ventricle in one case. There was cardiomegaly in two cases at the initial scan. The size of the fistulas increased during pregnancy in all except one. All prenatal diagnoses were confirmed postnatally. Among all, two patients developed congestive cardiac failure soon after birth and required transcatheter closure of the coronary artery fistula, 5 and 17 days after birth, respectively; three patients remained asymptomatic, and all of them showed progressive dilation of the feeding artery and had closure of the fistula at 20 months, 4 years, and 7 years of age, respectively. During the follow-up period, which ranged 2–14 years, all the patients were alive and well.ConclusionsCoronary artery fistulas can be diagnosed accurately during fetal life. Some babies may develop congestive cardiac failure soon after birth requiring early treatment. Those treated conservatively should be kept under review as intervention may be required later.

scholarly journals A Case of Coronary Cameral Fistula: When and How to Intervene?

2021 ◽  
Author(s):  
Mehdi Peighambari ◽  
Marziyeh Pakbaz ◽  
Azin Alizadehasl ◽  
Saeid Hosseini ◽  
Hamidreza Pouraliakbar
Keyword(s):  
Coronary Artery ◽  
Unusual Case ◽  
Coronary Artery Fistula ◽  
Circumflex Coronary Artery ◽  
Aged Woman ◽  
Complex Anatomy ◽  
Coronary Artery Fistulas ◽  
Middle Aged Woman ◽  
The Right

Coronary artery fistulas constitute a rare anomaly defined as an abnormal communication between a coronary artery and a great vessel or any cardiac chamber. The majority of these fistulas arise from the right coronary artery and the left anterior descending coronary artery; the circumflex coronary artery is rarely involved. We present an unusual case of a coronary artery fistula in a middle-aged woman who presented with symptoms of heart failure and abnormal auscultation. Echocardiography and conventional and computed tomography angiography showed that the coronary fistula originated from the left circumflex coronary artery and drained majorly into the right ventricle. Given the complex anatomy of the fistula, we managed it surgically rather than percutaneously. There were no complications early after surgery and at 1 year’s follow-up.

scholarly journals Left circumflex coronary artery aneurysm combined with fistula to the left ventricle

2020 ◽  
Author(s):  
Zhang Yue ◽  
Manwei Liu ◽  
Kailun Zhang ◽  
Yali Yang ◽  
Fei Li
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Rare Case ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Coronary Artery Fistula ◽  
Circumflex Coronary Artery ◽  
Right Heart ◽  
Left Circumflex Coronary Artery ◽  
The Right

Coronary artery fistula (CAF) are abnormal connections between a coronary artery and cardiac chambers or with other vessels. CAF occurs in about 0.1% of adult patients and most commonly affects the right heart. We present a rare case of left circumflex coronary artery aneurysm with fistula to the left ventricle.

Peratrial Device Closure of a Congenital Coronary Artery Fistula through a Right Parasternal Approach: Innovative Use of Available Technology

2016 ◽  
Vol 19 (1) ◽  
pp. 005
Author(s):  
Yanting Jia ◽  
Li Hongxin ◽  
Guo Wenbin ◽  
Haizhou Zhang ◽  
Chengwei Zou
Keyword(s):  
Coronary Artery ◽  
Surgical Techniques ◽  
Coronary Artery Fistula ◽  
Device Closure ◽  
Transcatheter Occlusion ◽  
Coronary Artery Fistulas ◽  
Congenital Coronary Artery Fistula ◽  
Right Parasternal Approach ◽  
Available Technology ◽  
The Right

Current treatments for congenital coronary artery fistulas (CAFs) include surgical obliteration and transcatheter occlusion. However, surgical techniques involve significant trauma. Transcatheter occlusion is performed under fluoroscopy and angiography, in which radiation injury is inevitable. We present a patient, with a CAF from the left coronary artery to the right atrium, who underwent peratrial device closure of the CAF with a right parasternal approach under transesophageal echocardiography guidance. Complete occlusion was achieved by a symmetric ventricular septal occluder. We suggest that peratrial device closure of a congenital coronary artery fistula through a right parasternal approach may be a safe and effective option.

scholarly journals Coronary Artery Fistula Diagnosed by Echocardiography during NSTEMI: Case Report and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Angelo Acitelli ◽  
Sabrina Bencivenga ◽  
Maria B. Giannico ◽  
Chiara Lanzillo ◽  
Luciano Maresca ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Incidental Finding ◽  
Coronary Artery Fistula ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Inferior Wall ◽  
Coronary Syndrome ◽  
Major Vessel ◽  
Coronary Artery Fistulas ◽  
The Right

Coronary artery fistulas are rare abnormal connections between a coronary artery and a cardiac chamber or a major vessel. Often, they are asymptomatic and the diagnosis is accidental. The case we present is the incidental finding of a fistula displayed with echocardiography during acute coronary syndrome (ACS). A 73-year-old man presented in the emergency room for non-ST-elevation ACS. Echocardiogram showed in a parasternal short axis view an abnormal diastolic flow inside the ventricular inferior wall. Angiography and CT confirmed the diagnosis of coronary fistula from the right coronary into the left ventricular cavity. A literature analysis with discussion about coronary fistulas classification and management was also performed.

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 Diffuse Coronary Artery Fistula Leading to Syncope and Treated with Transcatheter Coil Occlusion and a Defibrillator: A Case Report

2019 ◽  
Vol 28 (5) ◽  
pp. 493-496 ◽  
Author(s):  
Murat Meric ◽  
Serkan Yuksel
Keyword(s):  
Coronary Artery ◽  
Ventricular Fibrillation ◽  
Left Ventricle ◽  
Coronary Artery Fistula ◽  
Left Ventricular ◽  
Cardioverter Defibrillator ◽  
Coil Occlusion ◽  
Coronary Artery Fistulas ◽  
Clinically Significant ◽  
Nuclear Scanning

Objectives: Coronary artery fistulas connecting coronary arteries to cardiac cavities are rare but clinically significant anomalies. Clinical Presentation and Intervention: A 47-year-old male patient presented with syncope. Left ventricular dysfunction was detected on echocardiography. Extensive coronary fistulas draining into the left ventricle were found on coronary angiography. Ventricular fibrillation was induced on electrophysiology study. Because of the induction of ventricular fibrillation, extensive fistulas, and presence of other risk factors, an implantable cardioverter defibrillator was implanted. After the detection of ischemia by nuclear scanning, microcoil occlusion of the fistula was performed. Conclusion: The present case describes extensive fistulas complicated with fatal ventricular arrhythmias due to ischemia and left ventricle dysfunction. A cardioverter defibrillator was implanted to prevent sudden cardiac death.

scholarly journals Coronary Anomaly and Coronary Artery Fistula as Cause of Angina Pectoris with Literature Review

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jayanth Koneru ◽  
Anish Samuel ◽  
Meherwan Joshi ◽  
Aiman Hamden ◽  
Fayez E. Shamoon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Treatment Options ◽  
Coronary Artery Fistula ◽  
Left Main ◽  
Coronary Artery Fistulas ◽  
Diagnostic Modalities ◽  
Coronary Cusp ◽  
The Right ◽  
Right Coronary Cusp

Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA), and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.

Coronary artery fistula to the left ventricle

1987 ◽  
Vol 23 (3) ◽  
pp. 420
Author(s):  
B H Lee ◽  
S J Yu ◽  
E S Moon ◽  
S H Kim ◽  
Y H Choi
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Coronary Artery Fistula
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