Coronary Fistula from Left Main Stem to Main Pulmonary Artery

Department of Cardiology, Laiko Hospital of Athens, Athens, Greece.
The Journal of invasive cardiology (Impact Factor: 0.95). 11/2003; 15(10):600-1.
Source: PubMed


We describe a patient with a rare coronary arteriovenous fistula connecting the left main stem to the main pulmonary artery. This rare case was discovered during routine coronary angiography for the evaluation of the patient s coronary heart disease.

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    • "The main indications for closure of CAF are clinical symptoms, particularly heart failure and myocardial ischemia and, in asymptomatic patients with high-flow shunting, to prevent occurrence of undesirable complications [2]. Surgical intervention to correct the fistula is recommended for symptomatic patients and for those asymptomatic patients at risk for future complications such as bacterial endocarditis, thrombosis, distal embolization, aneurysm, dissection, rupture, premature atherosclerosis, pulmonary hypertension, myocardial ischemia or infarction [2,8,9]. The increased experience and the improved devices and techniques provide a variety of therapeutic options. "
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    ABSTRACT: Patient: Male, 69 Final Diagnosis: Coronary artery to pulmonary artery fistula Symptoms: Chest pain Medication: - Clinical Procedure: Echocardiography • angiography • surgical intervention Specialty: Cardiology • Cardiac Surgery. Rare disease. A coronary artery fistula is an abnormal communication between a coronary artery and one of the cardiac chambers or a great vessel, so bypassing the myocardial capillary network. They are usually discovered incidentally upon coronary angiography. Clinical manifestations are variable depending on the type of fistula, the severity of shunt, site of shunt, and presence of other cardiac condition. We report a 69-year-old man without any previous medical history, who was admitted to our hospital with chest pain. The electrocardiogram (ECG) showed a sinus rhythm with ST depression in V2 to V6 precordial leads. Coronary angiography revealed a coronary artery fistula from left anterior descending coronary artery (LAD) to the main pulmonary artery, right coronary artery blockage and significant stenoses on the LAD and left circumflex artery (LCX). Surgical treatment was chosen because of the total occlusion of the right coronary artery and to relieve of pain to improve quality of life.
    American Journal of Case Reports 11/2013; 14:486-488. DOI:10.12659/AJCR.889416
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    ABSTRACT: Coronary artery aneurysm is an uncommon disease. Coronary artery fistulae are infrequent congenital anomalies. A extremely rare case report of combination of coronary artery aneurysms and coronary artery fistula is presented with a brief literature review.
    Clinical Anatomy 01/2005; 18(1):77-8. DOI:10.1002/ca.20034 · 1.33 Impact Factor
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    ABSTRACT: Coronary artery aneurysms are noted in 0.15% to 4.9% of patients undergoing coronary angiography. Atherosclerosis accounts for 50% of coronary aneurysms in adults. 1 We report a 64-year-old female with a huge right coronary artery aneurysm with fistula connecting the aneurysm with the pulmonary artery and a fistula connecting the proximal left anterior descending artery with the pulmonary artery. Surgical resection of the coronary artery aneurysm and suture ligation of the coronary artery fistulas were performed. Pathological examination disclosed aneurysm with focal fibrosis and calcification. The patient presenting shortness of breath and angina-like symptoms caused by a huge right coronary artery aneurysm with compression of right ventricular outflow tract made this case noteworthy. The patient's symptoms resolved after surgical intervention.
    Acta Cardiologica Sinica 03/2006; 22(1). · 0.33 Impact Factor
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