A Case of latrogenic Fistula Between the Left Internal Mammary Artery and the Pulmonary Vessels

Abstract

In 1977 Angiology published a paper of Edmiston et al.1 entitled "Angiographic demonstration of an acquired internal mammary-to-pulmonary artery fistula." These authors described a case of a 25 year old man in whom a spontaneous left pneumothorax was treated with a chest tube placed anteriorly at the level of the second intercostal space. Twenty months later, a continuous murmur was appreciated at the level of the third intercostal space, 2 cm medial to the midclavicular line. A selective catheterization of the left internal mammary artery revealed a network of vessels connected with the pulmonary artery. A relationship between the previous placement of the tube and the development of the fistula was hypothesized, whereas this malformation is thought to be usually congenital. In the present report we describe another case of fistula between the left internal mammary artery and the pulmonary vessels, following to a spontaneous pneumothorax. Also in this case it may be hypothesized as an iatrogenic origin.