scholarly journals Percutaneous closure of a fistula from the left circumflex coronary artery to the coronary sinus in an infant

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110217
Author(s):  
Yun Bao ◽  
Tian-Yuan Xiong ◽  
Xiao Li ◽  
Yuan Feng
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Coronary Artery Fistula ◽  
Percutaneous Closure ◽  
Circumflex Coronary Artery ◽  
Vascular Plug ◽  
Left Circumflex Coronary Artery ◽  
Great Vessels ◽  
Rare Situation

Coronary artery fistula is an abnormal direct connection between the coronary artery and any of the four chambers of the heart or great vessels. A fistula from the left circumflex coronary artery to the coronary sinus is a relatively rare situation. We report a case of 12-month-old infant with coronary artery fistula from the left circumflex coronary artery to the coronary sinus that was identified incidentally. The N-terminal pro-brain natriuretic peptide level was elevated. Additionally, the proximal segment of the left circumflex coronary artery was dilated. On the basis of these findings, percutaneous closure of the fistula was performed with a vascular plug. This procedure achieved no residual flow and good hemodynamics were observed during follow-up.

scholarly journals Successful percutaneous occlusion of a large left circumflex coronary artery fistula draining into the coronary sinus using a ventricular septal defect occluder: a case report

2020 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Anastasia D Egorova ◽  
Peter Ewert ◽  
Martin Hadamitzky ◽  
Andreas Eicken
Keyword(s):  
Coronary Artery ◽  
Ventricular Septal Defect ◽  
Coronary Sinus ◽  
Septal Defect ◽  
Heart Defects ◽  
Coronary Artery Fistula ◽  
Circumflex Coronary Artery ◽  
Left Circumflex Coronary Artery ◽  
Complex Anatomy

Abstract Background Coronary artery fistula (CAF) is a congenital anomaly of the coronaries that can lead to significant intracardiac shunting and myocardial ischaemia. Case summary We describe the case of a 15-year-old male with an incidentally documented precordial cardiac murmur. An evidently dilated coronary sinus (CS) on transthoracic echocardiography prompted further investigation. A computed tomography (CT) revealed the presence of a large CAF from the left circumflex coronary artery to the CS. No other structural heart defects were detected. A haemodynamically significant intracardiac shunt was confirmed during cardiac catheterization, and it was decided to close the fistula. This was successfully performed using a ventricular septal defect (VSD) occluder (Konar 10-8, Lifetech Scientific) that was deployed through a 6 Fr right coronary guiding catheter. A partial thrombotic occlusion of the CS behind the closure device was noted during follow-up which led to anticoagulation in a higher target INR range and concomitant start of low dose carbasalate calcium to reduce further retrograde thrombus extension. Patient is doing well at over 1 year of follow-up, and no further thrombotic extension into the CS was seen on a recent CT. Discussion This report illustrates the diagnostic workup and a percutaneous treatment strategy of a CAF using a VSD occluder. We also describe a not previously reported complication, thrombotic CS occlusion. Improving transcatheter techniques and marketing of novel devices with a broad spectrum of applications can offer new opportunities for treating CAF and avoiding surgical correction often involving cardiopulmonary bypass, reserving this option for patients with complex anatomy or failed transcatheter closure.

scholarly journals A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair

2020 ◽  
Author(s):  
Giulia Poretti ◽  
Mauro Lo Rito ◽  
Alessandro Varrica ◽  
Alessandro Frigiola
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Giant Aneurysm ◽  
Coronary Aneurysm ◽  
Coronary Artery Fistula ◽  
Percutaneous Closure ◽  
Low Flow ◽  
Circumflex Artery ◽  
Coronary Aneurysms

Abstract Background Isolated coronary arteriovenous fistulas are extremely rare, accounting for 0.08–0.4% of all congenital heart disease. Closure of the fistula is recommended in cases of large dimensions, relevant left–right shunt, or ischaemic events. Thrombosis of the coronary aneurysms may occur as a postoperative complication. Case summary We report a case of a coronary fistula between the circumflex artery and coronary sinus with giant aneurysm. After a failed percutaneous closure attempt, the patient was surgically treated without major postoperative complications. Despite therapeutic anticoagulation and antiplatelet therapy, she presented at clinical follow-up with thrombosis of the dilated coronary artery without signs or symptoms of ischaemia. Discussion Management of coronary artery fistula may be challenging in cases in which initial percutaneous closure is unsuccessful. This particular case also highlights the importance of close follow-up, despite optimal therapy, to detect potentially lethal complications related to the low flow in the dilated coronary aneurysm.

scholarly journals Unusual echocardiographic image of a left circumflex coronary artery with anomalous origin from the right coronary sinus

2015 ◽  
Vol 37 (9) ◽  
pp. 792-792
Author(s):  
Stefano Bonapace ◽  
Edoardo Adamo ◽  
Carmelo Cicciò ◽  
Andrea Chiampan ◽  
Guido Canali ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Anomalous Origin ◽  
Circumflex Coronary Artery ◽  
Left Circumflex Coronary Artery ◽  
Echocardiographic Image ◽  
The Right

scholarly journals A Rare Case of a Giant Coronary Sinus with Focal Aneurysm Secondary to Multiple Fistulous Connections Arising from a Dilated, Tortuous Left Circumflex Coronary Artery

CASE ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 99-102
Author(s):  
Natalie F.A. Edwards ◽  
Vishva A. Wijesekera ◽  
Bonita A. Anderson ◽  
Mohsen Habibian ◽  
Darryl J. Burstow ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Rare Case ◽  
Circumflex Coronary Artery ◽  
Left Circumflex Coronary Artery

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.

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