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.

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 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.

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 Successful Revascularization to Right Coronary Artery by Percutaneous Coronary Intervention after Endovascular Therapy for Leriche Syndrome

2014 ◽  
Vol 7 ◽  
pp. CCRep.S13551 ◽  
Author(s):  
Takeshi Niizeki ◽  
Kazuyoshi Kaneko ◽  
Shigeo Sugawara ◽  
Toshiki Sasaki ◽  
Yuichi Tsunoda ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Endovascular Therapy ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Inferior Wall ◽  
Leriche Syndrome ◽  
Percutaneous Coronary ◽  
The Right

A 69-year-old man with effort angina was admitted to our institution. Echocardiography showed poor left ventricular systolic function with akinesis of the anterior wall and severe hypokinesis of the inferior wall. We performed coronary angiography, which revealed two diseased vessels including chronic total occlusion in the left anterior descending artery and severe stenosis in the right coronary artery (RCA). In addition, aortography revealed aortoiliac occlusive disease known as Leriche syndrome. As the patient's symptom was stable, we first planned to perform endovascular therapy (EVT) for Leriche syndrome to make a route for intra-aortic balloon pumping. We prepared a bi-directional approach from bi-femoral arteries and a left brachial artery. The guidewire was passed through the occlusive area using the retrograde approach. The self-expanding stents were deployed by a kissing technique. At one week after EVT, a 6Fr sheath was inserted from the right radial artery and an intra-aortic balloon pump was successfully inserted through the right femoral artery for percutaneous coronary intervention (PCI) to the RCA. Two drug-eluting stents were successfully deployed to RCA after using an atherectomy device (rotablator). We reported the case as a successfully performed PCI to the RCA after EVT for Leriche syndrome.

Single right coronary artery with right ventricular fistula and congenital absence of left coronary artery: an extremely rare combination

2019 ◽  
Vol 29 (11) ◽  
pp. 1402-1403
Author(s):  
Tamer Yoldaş ◽  
Meryem Beyazal ◽  
Utku A. Örün
Keyword(s):  
Coronary Artery ◽  
Right Ventricle ◽  
Right Coronary Artery ◽  
Left Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Ventricular ◽  
Congenital Absence ◽  
Collateral Vessels ◽  
The Right ◽  
Single Right Coronary Artery

AbstractWe report an extremely rare case of a 14-month-old girl who was diagnosed with a single right coronary artery with coronary artery fistula communicating with the right ventricle and congenital absence of left coronary artery. Angiography showed a dilated and tortuous single right coronary artery draining into the right ventricle, absence of left coronary system, and left ventricular coronary circulation supplied via collateral vessels.

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.

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 Multivessel percutaneous coronary intervention with bifurcation stenting in a quadfurcated single coronary artery from the right aortic sinus: a case report

2019 ◽  
Author(s):  
Mohammed Al Jarallah ◽  
Rajesh Rajan ◽  
Vladimir Kotevski ◽  
Raja Dashti ◽  
Wagdy Moustafa
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Single Coronary Artery ◽  
Inferior Wall ◽  
Aortic Sinus ◽  
Coronary Syndrome ◽  
Multiple Lesions ◽  
Percutaneous Coronary ◽  
The Right

Abstract Background Quadfurcation of single coronary artery (SCA) from the right is an extremely rare anomaly and acute coronary syndrome in such patients is catastrophic. Case summary We report a 56-year-old Bangladeshi male who presented with an acute inferior wall ST-elevation myocardial infarction. He was taken to the Cath lab for primary percutaneous coronary intervention which showed the presence of SCA arising from the right aortic sinus with multiple lesions including a bifurcation lesion. Percutaneous coronary intervention was done successfully in two sessions. Discussion Tackling multiple lesions in a case of SCA with quadfurcation was challenging especially in the setting of SCA and bifurcation lesions. This is first reported case of this kind.

Young man presenting with out-of-hospital cardiac arrest

Heart ◽  
2018 ◽  
Vol 104 (21) ◽  
pp. 1771-1802 ◽  
Author(s):  
Hans David Huang ◽  
William L Lombardi ◽  
Zachary Louis Steinberg
Keyword(s):  
Cardiac Arrest ◽  
Coronary Artery ◽  
Left Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inferior Wall ◽  
List Type ◽  
The Right ◽  
Left Anterior Oblique ◽  
Hospital Cardiac Arrest

Clinical introductionA man in his early 30s with remote history of a febrile rash as a toddler presented to the emergency room following an out-of-hospital cardiac arrest while riding his bicycle. He received bystander cardiopulmonary resuscitation and one shock from an automatic external defibrillator, successfully restoring sinus rhythm. On arrival, he was haemodynamically stable without ECG evidence of ST segment changes to suggest active ischaemia, and an initial troponin I was mildly elevated at 0.10 ng/mL (normal <0.04 ng/mL). A CT angiogram (CTA) was obtained showing a normal-appearing aorta and no abnormal extracardiac findings. Urgent coronary angiography was performed; images are shown in figure 1A–C. Echocardiogram revealed a mildly reduced left ventricular ejection fraction (45%) with a hypokinetic inferior wall.Figure 1(A) Right coronary artery angiogram in the left anterior oblique cranial projection. (B) Left coronary artery angiogram in the right anterior oblique caudal projection. (C) Left coronary artery angiogram in the right anterior oblique cranial projection. CAUD, caudal; CRAN, cranial; LAO, left anterior oblique; RAO, right anterior oblique.QuestionWhat is the next best step in the management of this patient at this time?Complete revascularisation via percutaneous coronary intervention (PCI).Referral for coronary artery bypass surgery (CABG).Initiation of high-dose steroids.Initiation of dual-antiplatelet therapy without planned revascularisation.

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