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 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.

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.

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

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 A RARE CASE OF LARGE DIFFUSE BILATERAL RIGHT AND LEFT CORONARY ARTERY FISTULAS TERMINATING IN THE LEFT VENTRICLE

2021 ◽  
Vol 77 (18) ◽  
pp. 2434
Author(s):  
Iyad Farouji ◽  
Omar Alradaideh ◽  
Hossam Abed ◽  
Zaid Amin ◽  
Dilesha Kumanayaka ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Rare Case ◽  
Left Coronary Artery ◽  
Coronary Artery Fistulas

scholarly journals Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Murat Yuksel ◽  
Abdulkadir Yildiz ◽  
Mustafa Oylumlu ◽  
Nihat Polat ◽  
Halit Acet ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
Ventricular Rate ◽  
Fistula Formation ◽  
New Onset

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

scholarly journals Implantable cardioverter-defibrillator oversensing due to electric shock

2010 ◽  
Vol 138 (3-4) ◽  
pp. 236-239
Author(s):  
Ruzica Jurcevic ◽  
Lazar Angelkov ◽  
Dejan Vukajlovic ◽  
Velibor Ristic ◽  
Milosav Tomovic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Sinus Rhythm ◽  
Implantable Cardioverter Defibrillator ◽  
Electric Shock ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Circumflex Artery ◽  
Ventricular Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
First Case

Introduction. We described the first case of oversensing due to electric shock in Serbia, in a 54-year-old man who had implantable cardioverter-defibrillator (ICD). Case Outline. In July 2002, the patient had acute anteroseptal myocardial infarction and ventricular fibrillation (VF) which was terminated with six defibrillation shocks of 360 J. Coronary angiography revealed 30% stenosis of circumflex artery, the left anterior descending coronary artery was recanalized and the right coronary artery was without stenosis. Left ventricular ejection fraction was 20%. In December 2003, an electrophysiology study was performed and ventricular tachycardia (VT) was induced and terminated with 200 J defibrillation shock. Single chamber ICD Medtronic Gem III VR was implanted in January 2004 and defibrillation threshold was 12 J. The patient was followed up during three years every three months and there were no VT/VF episodes and VT/VF therapies. In December 2007, the patient experienced electric shock through the fork while he was making barbecue on the electric grill. ICD recognized this event in VF zone (oversensing) and delivered defibrillation shock of 18 J. The electrogram of the episode showed ventricular sensing - intrinsic sinus rhythm with electric shock potentials which were misidentified as VF. After charge time of 3.16 seconds, ICD delivered defibrillation shock and sinus rhythm was still present. Conclusion. Oversensing of ICD has different aetiology and the most common cause is supraventricular tachyarrhythmia.

Regional Left Ventricular Systolic Function in Humans During Off-Pump Coronary Bypass Surgery

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Philip M. Brown ◽  
Victor B. Kim ◽  
Bret J. Boyer ◽  
Robert M. Lust ◽  
W. Randolph Chitwood ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Stenosis ◽  
Systolic Function ◽  
Coronary Bypass ◽  
Inverse Correlation ◽  
Left Ventricular Pressure ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Off Pump ◽  
Clinically Significant

Background —Controversy exists as to whether off-pump CABG with local occlusion results in clinically significant myocardial ischemia during the occlusion period. This study was undertaken to delineate the effects of transient local coronary artery occlusion on regional systolic function. Methods and Results —Eight consenting patients undergoing left internal mammary to left anterior descending coronary artery (LAD) bypass were instrumented with a left ventricular pressure catheter and 2 subepicardial cylindrical ultrasonic dimension transducers placed in the minor axis dimension in the region served by the LAD. A digital sonomicrometer was used to collect data before, during, and after coronary occlusion from which percent systolic shortening and pressure-dimension loops were derived. Measuring devices were removed immediately after the final time point. All patients tolerated the procedure well, and there were no complications. Average duration of local occlusion needed for CABG was 15.9±4.4 minutes (range, 12 to 26 minutes). Local occlusion was associated with a decrease in peak systolic shortening from 5.8±0.8% to 1.8±0.8%. In all cases, function returned to baseline after restoration of flow. Pressure-dimension loops confirmed these findings and no evidence of diastolic creep. Linear repression analysis of degree of stenosis versus change in segmental shortening revealed a significant inverse correlation. Conclusions —Local occlusion of the LAD resulted in a transient decrease in myocardial function during occlusion with complete recovery during reperfusion. This change was less significant with increasing degrees of coronary stenosis. These data suggest that local occlusion is not associated with permanent myocardial injury but that ischemic changes do occur that may be clinically significant, especially in patients with lesser degrees of coronary stenosis.

Algorithm for diagnosis and typing of ALCAPA syndrome

2021 ◽  
Vol 3 (2) ◽  
pp. 01-07
Author(s):  
Mariela Céspedes Almira ◽  
Adel Eladio González Morejón ◽  
Giselle Serrano Ricardo ◽  
Tania Rosa González Rodríguez ◽  
Judith Escobar Bermúdez
Keyword(s):  
Coronary Artery ◽  
Left Ventricle ◽  
Left Coronary Artery ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Volume Index ◽  
Cross Sectional ◽  
End Diastolic Volume ◽  
Congenital Origin ◽  
Diagnostic Modalities

ALCAPA syndrome was characterized by anomalous origin of left coronary artery from pulmonary artery. Its clinical presentation is varied and although it is an anomaly of congenital origin, it is not exclusive to pediatric ages. Its epidemiological documentation is difficult. We aimed to make the non-invasive diagnosis of the ALCAPA syndrome and its variants. An observational, prospective and cross-sectional study was conducted with 31 patients with a positive echocardiographic diagnosis of ALCAPA syndrome at Pediatric Cardio Center “William Soler” from 2005 to 2018. The variables with significance for diagnosis were the echocardiographic visualization of the anomalous connection and the reversed flow in the left coronary artery. The variables with significance for typing were age at diagnosis, ischemia in the electrocardiogram, echocardiographic visualization of left ventricle papillary muscles fibrosis, presence of severe mitral regurgitation, left ventricle spheroidal remodeling, left ventricle ejection fraction, left ventricular end-diastolic volume index, and left ventricular end-diastolic diameter index. An algorithm integrated by various diagnostic modalities associated with echocardiography as a tool for the detection of ALCAPA was developed. The documentation of the diagnostic and classificatory aspects of the syndrome is possible by detecting echocardiographic elements in conjunction with electrocardiographic and radiological aspects.

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