Dual Coronary Artery Fistula from Left Anterior Descending and Right Coronary Artery to Pulmonary Trunk in a Patient with Myocardial Infarction—A Case Report (original) (raw)
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Journal of the Saudi Heart Association, 2012
Coronary artery fistulae are rare congenital or acquired connections between the coronary vessels and the cardiac chambers or other vascular structures. We present two consecutive cases of coronary fistulae between the proximal left anterior descending artery (LAD) and the main pulmonary artery. Both cases where admitted with history of acute coronary syndromes and had multivessel coronary disease along with coronary pulmonary fistulae. The two cases were managed by coronary artery bypass grafting (CABG) and repair of the fistulae.
Double Coronary Artery Fistulae: Clinical and Imaging Concerns, and a Review of the Literature
European Journal of Case Reports in Internal Medicine, 2015
Coronary artery fistulae (CAF) are a rare entity describing abnormal communication between a coronary artery and cardiac chamber or a large intrathoracic vessel and are seldom described in the literature . These fistulae can be either congenital or acquired. Often incidental in finding, CAFs can have serious clinical sequelae, and should be duly reported and discussed with the cardiac team. More than 50% of patients with CAFs may be asymptomatic; 34% may report chest pain; 13% may have symptoms of heart failure, and a minority of 2% may suffer from endocarditis and arrhythmias . The largest series to our knowledge was reported by the Cleveland Clinic, which found 225 patients with incidental CAF out of 126,595 coronary catheterizations (incidence of 0.18%), performed during a span of 28 years . Multiple CAFs are an even rarer entity and only a handful of cases have been reported in the literature to date. Few cases of double CAFs have been reported that describe two different feeder coronary arteries giving rise to separate drainage sites . In our report, however, we describe a new entity: a single-feeder coronary vessel communicated with two drainage sites. Our case is curiously unique, in which we report a single artery, originating from the right coronary artery (RCA) with double drainage sites -one to the left pulmonary artery and the second to the left bronchial artery.
Coronary Artery Fistulas Between Coronary and Pulmonary Arteries: Case Reports
Journal of Clinical and Analytical Medicine, 2016
Konjenital koroner arter fistülü bir koroner arter ile diğer vasküler yapılar arasında direkt bağlantının olduğu nadir, izole bir anomalidir. Biz biri perkütan koil embolizasyon uygulaması ile, diğeri cerrahi olarak tedavi edilmiş iki konjenital koroner arteriyovenöz fistüllü vakayı sunduk.
Annals of Dermatological Research
Between coronary artery anomalies, myocardial bridging means an epicardial coronary artery, mostly left anterior descending artery (LAD), running through an intramyocardial “tunnel” (usually in the middle segment), leading during systolic contraction, flow reduction, through the vessel. When this anomaly is associated with a coronary fistula, which “steals” more from the bloodstream, the symptoms are more pronounced, and the management complex is surgical in particular. Despite the presence from birth remains asymptomatic and it becomes clinically manifest later in the third to fourth decade of life, with a diverse palette of symptoms; angina, arrhythmias, and acute myocardial infarction up to sudden death. Diagnosis and particular management, medical, interventional, and surgical should avoid major cardiac complications and sudden death. We present two adult patients, with coronary artery bridging, one case associated with coronary artery fistula, LAD to pulmonary artery trunk, ver...
Medicine, 2017
Cases of coronary artery fistula having a connection with the cardiac cavity are rare. Here, we report a case in which 2 coronary arteries empty into the left ventricular cavity together. A 63-year-old woman who was diagnosed as having hypertension 20 years prior presented with dyspnea. The coronary angiography revealed coronary artery fistula. Chest X-ray showed pulmonary edema. Transthoracic echocardiography revealed moderately decreased left ventricular (LV) function and increased LV end-diastolic volume and mass index. Coronary angiography and cardiac computed tomography revealed that 2 coronary arteries joined together at the distal end and directly drained into the left ventricular cavity bypassing the myocardial capillary vessels. We started medical treatment for heart failure with an angiotensin-converting-enzyme inhibitor, loop diuretic, and spironolactone. The pulmonary edema improved rapidly. The patient did not experience dyspnea after discharge, and follow-up echocardio...
Symptomatic bilateral coronary artery fistula to pulmonary artery in elderly patient
European journal of radiology open, 2016
We report the imaging findings of an uncommon coronary vascular termination anomaly, with fistula to the pulmonary artery. This 70 year old female patient presented unstable angina, showing a coronary artery fistula depicted in coronary angiogram from the left coronary to the pulmonary artery, with no significant atherosclerotic pathology. Due to development of ventricular tachycardia in stress echocardiogram examination, she was proposed for coronary fistula closure. Coronary CT was performed for procedure planning and allowed the identification of a second unsuspected fistula from the right coronary to the right pulmonary artery. Congenital coronary anomalies are a possible cause of symptomatic coronary pathology in patients of any age. In older patients, coronary artery fistulas are rare, especially when symptomatic. Adequately performed CT examinations, using its post processing capabilities, with 3D and MIP reconstructions are invaluable in delineating coronary anatomy, essenti...
Congenital Heart Disease, 2007
We report 2 cases of infants presenting with a murmur shortly after birth and diagnosed with coronary artery fistulas with drainage into the left atrium. The first infant had a fistulous communication between the left main coronary artery and the left atrial appendage and presented with signs and symptoms of heart failure. The infant was repaired surgically in the first week of life. The second infant was asymptomatic and had a fistulous communication between the right coronary artery and the left atrium. The infant will have the fistula closed in the cardiac catheterization laboratory when the child is older. The literature on coronary artery fistulas is reviewed, and the diagnosis and management of coronary artery fistulas is discussed.