Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature (original) (raw)
Related papers
Coronary-to-bronchial artery fistula in a patient with angina
Journal of Cardiology Cases, 2013
Coronary-to-bronchial artery fistulae are the most common found in adulthood and have often been associated with bronchiectasis and other abnormalities of pulmonary parenchyma. In this study we describe an unusual case in which circumflex coronary artery-to-left bronchial artery fistula was associated with the presence of extensive aneurysmatic dilatation of thoracic arteries. <Learning objective: This report deals with the case of a coronary-to-bronchial artery fistula (CAF) as the cause of atypical angina in a patient with normal coronary arteries. The concomitant finding of aneurysmatic dilatation of thoracic arteries controindicated an invasive approach. Medical therapy with vasodilators and anti-anginal drugs was soon started proving to be efficacious in symptoms relief.>
International Journal of Cardiovascular and Thoracic Surgery, 2019
Coronary artery fistulas (CAF) are rare but hemodynamically significant anomalies. Although asymptomatic, they can be associated with several cardiorespiratory conditions. Coronary to bronchial fistulas (CBF) account for 0.5% to 0.61% of coronary artery fistulas, with fistulas arising from the right coronary artery being exceedingly rare. These fistulas are known to be associated with bronchiectasis but not lung bullae. The following paper reports a rare case of a coronary to bronchial fistula associated to bronchiectasis and lung bullae. The patient presented for dyspnea and was found to have a large lung bullae, bronchiectasis and a coronary to bronchial artery fistula arising from the right coronary artery and terminating into the left bronchial artery. The CBF was successfully managed first with percutaneous microcoil embolization then the bullae was resected thoracoscopically three days later. However, more case reports are mandatory in order to further understand the etiology and pathophysiology of these fistulas, elucidate their relationship to other pathologies such as bronchiectasis and lung bullae and determine the optimal therapeutic measures.
Coronary pulmonary artery fistula: A case series with review of the literature
Objective: To describe the clinical, angiographic profile and management strategies of patients of coronary pulmonary arterial fistulas presenting to a tertiary care center in a developing country. Methods: All patients with coronary pulmonary artery fistula (CPAF) diagnosed using coronary angiogram in last two years i.e. 2011-2013 in a tertiary care center in South India were included in the study. Ten adult patients were treated for coronary pulmonary artery fistulas. Results: Mean age was 56± 7.7 years (range 45-80 years) with no gender preponderance. Chest pain was the predominant symptom in 60 % of patients followed by giddiness and syncope. Only 20 % patients were found to have continuous or systolic murmur on auscultation. Majority of the fistulas were found to be originating from the left anterior descending artery (LAD), most commonly from proximal segment (n = 5). Majority (n = 9) responded to conservative management while one patient required surgical intervention. Conclusion: Coronary pulmonary arterial fistulas are rare coronary anomaly which often goes unnoticed. CPAF was most frequently seen in middle age with male preponderance arising from proximal LAD. Patients present with diverse clinical presentations and subtle clinical findings. Majority of them being functionally insignificant, need only conservative measures.
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.
Coronary-pulmonary fistula: long-term follow-up in operated and non-operated patients
International Journal of Cardiology, 1990
Eleven cases with 13, incidentally found coronary-pulmonary fistulous communications were discovered out of about 11000 diagnostic coronary angiograms performed in different patients, over the period 1968 to 1989. These patients were followed-up for an average period of 4.4 years (range 2-11 years). The majority had a fistuious malformation originating from the proximal part of the left anterior descending artery and terminating in the pulmonary trunk. In three subjects, the right coronary artery participated in formation of the shunt. The fistulas consisted either of a convoluted mass of serpentive vessels, sometimes with aneurysmal formation, or of a solitary single vessel. Angina pectoris, atypical chest pain and fatigue were the most common symptoms. All patients were treated conservatively except one, who underwent ligation of the fistula and coronary arterial bypass grafting. Two subjects are still free of symptoms. No death occurred. None of the patients developed subacute bacterial endocarditis, acute myocardial infarction or left ventricular failure during the period of follow-up of more than four years. Three individuals, prior to the follow-up period, had suffered myocardial infarction contralateral to the shunt. They had no recurrence.
Coronary artery fistulas: Clinical and therapeutic considerations
International Journal of Cardiology, 2006
Coronary artery fistulas vary widely in their morphological appearance and presentation. These fistulas are congenital or acquired coronary artery abnormalities in which blood is shunted into a cardiac chamber, great vessel, or other structure, bypassing the myocardial capillary network. 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. Clinical manifestations vary considerably and the long-term outcome is not fully known. The patients with coronary fistulas may present with dyspnea, congestive heart failure, angina, endocarditis, arrhythmias, or myocardial infarction. A continuous murmur is often present and is highly suggestive of a coronary artery fistula. Differential diagnosis includes persistent ductus arteriosus, pulmonary arteriovenous fistula, ruptured sinus of Valsalva aneurysm, aortopulmonary window, prolapse of the right aortic cusp with a supracristal ventricular septal defect, internal mammary artery to pulmonary artery fistula, and systemic arteriovenous fistula. Although noninvasive imaging may facilitate the diagnosis and identification of the origin and insertion of coronary artery fistulas, cardiac catheterization and coronary angiography is necessary for the precise delineation of coronary anatomy, for assessment of hemodynamics, and to show the presence of concomitant atherosclerosis and other structural anomalies. Treatment is advocated for symptomatic patients and for those asymptomatic patients who are at risk for future complications. Possible therapeutic options include surgical correction and transcatheter embolization. Historical perspectives, demographics, clinical presentations, diagnostic evaluation, and management of coronary artery fistula are elaborated. D
Atypical Presentation of Coronary Artery Fistula: Case Report and Review of the Literature
Cureus, 2020
Chest pain is one of the common complaints a patient presents to the healthcare provider. It needs prompt evaluation to determine the cause and origin. Angina occurs when myocardial oxygen demand exceeds oxygen supply; the clinical manifestation is often chest discomfort. Atherosclerotic disease is the major cause of angina. However, several non-atherosclerotic conditions have been studied and reported in the literature that causes angina in rarity. We describe a case of coronary artery fistula (CAF) likely causing angina.