scholarly journals Giant Circumflex Coronary Artery Fistula Draining into the Coronary Sinus

2014 ◽  
Vol 1 (4) ◽  
Author(s):  
Emiliano Navarra
2020 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Anastasia D Egorova ◽  
Peter Ewert ◽  
Martin Hadamitzky ◽  
Andreas Eicken

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.


2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110217
Author(s):  
Yun Bao ◽  
Tian-Yuan Xiong ◽  
Xiao Li ◽  
Yuan Feng

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.


2017 ◽  
Vol 3 (3-4) ◽  
pp. 96-97
Author(s):  
Jetsen A. Rodriguez ◽  
Limael E. Rodriguez ◽  
Manuel Santiago-Cummings ◽  
Ernesto R. Soltero

2011 ◽  
Vol 14 (4) ◽  
pp. 255 ◽  
Author(s):  
Fotios A. Mitropoulos ◽  
Meletios A. Kanakis ◽  
Periklis A. Davlouros ◽  
George Triantis

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.


2012 ◽  
Vol 61 (04) ◽  
pp. 333-335
Author(s):  
Emre Ozker ◽  
Uygar Yoruker ◽  
Can Vuran ◽  
Riza Turkoz ◽  
Bulent Saritas

Author(s):  
Giulia Poretti ◽  
Mauro Lo Rito ◽  
Alessandro Varrica ◽  
Alessandro Frigiola

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.


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