Case Of Coronary Artery Fistula Research Articles

Long-term outcome of interventional approaches for treatment of coronary artery fistulas: a retrospective cohort study in a great referral center

BackgroundDespite the spontaneous regression of many cases of coronary artery fistulas (CAFs), symptomatic patients or cases with severe shunting may require therapeutic interventions. In the present study, we aimed to assess the outcome of treatment of CAFs using interventional approaches.MethodsThis retrospective cohort study was performed on 29 patients with CAFs that were referred to our tertiary center between 2009 and 2019. Baseline characteristics were collected by reviewing the hospital files, and the patients were followed up to assess long-term outcomes with a mean follow-up of 3.3 years.ResultsOverall, in 29 patients in our cohort study, 82.9% suffered from isolated CAFs and in the remaining cases, concurrent congenital abnormalities did exist. For treatment, coils (Cook, Pfm, Ev3) were used in 79.3%, ADO II(AGA) in 18.3%, vascular plug (AGA) in 3.4%, and a combination of coil/ vascular plug/amplatzer in 3.4%. Postoperative complications were reported in 4 patients as external iliac artery thrombosis, transient PSVT, ST-T wave changes and mild pericardial effusion that were all managed successfully with no adverse sequels. No coronary artery injury, device dislocation, dissection, ischemia or coronary dilatation occurred, and there was no death. As larger fistulas were treated by a retrograde approach through the right side of the heart, there was significant correlation between residual shunts and the mode of closure approach; the majority of the residual shunts occurred in patients in the retrograde approach group.ConclusionsTrans-catheter approach for treating CAFs leads to appropriate long-term outcome with minimal potential side effects.

Transcatheter Closure of Cardiac Defects with Lifetech™ Konar-MultifunctionalOccluder Experience in a Tertiary Care Center

Objective: To assess the immediate and short-term efficacy and safety of transcatheter closure of cardiac defects with Lifetech™ Konar-MFO in a Tertiary Cardiac Care Center.
 Study Design: Descriptive cross-sectional study.
 Setting and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Mar 2019 to Dec 2021 
 Methodology: Patients of all ages and both gender undergone transcatheter closure of a cardiac defect with Konar-MFO from Jan 2021 to Dec 2021 were included in the study through non-probability consecutive sampling and approval by the institutional ethical review committee was taken prior to data collection. Data of patients undergone transcatheter closure with Konar-MFO from Mar 2019 to Dec 2020 was extracted retrospectively to assess the immediate and short-term efficacy and safety of the occluder. SPSS version-23 was used for data entry and analysis.
 Results: A total of 138 patients had transcatheter closure of a cardiac defect with Lifetech™ Konar-MFO during the study period. Case of VSD were 124(89.9%), PDA 9(6.5%), post-operative cases were 4(2.9%) along with 1(0.7%) case of coronary artery fistula (CAF) to the right ventricle. Out of 138 patients, 73(52.9%) were females while 65(47.1%) were males. The mean age was 9.3 ±8.1 years with a range of 6 months to 36 years. Mean fluoroscopy time was 13.68±9.74 min. The procedure was successful in 137(99.27%) cases. The device embolized in 2(1.45%) cases.
 Conclusion: In selected cases of VSD, PDA and in some post-operative cases the occlusion with Lifetech™ Konar-MFO is safe and efficacious with the added benefits of softness and versatility of the approach.

CTA analysis of 482 cases of coronary artery fistula: A large-scale imaging study.

The prevalence of coronary artery fistula (CAF) based on coronary angiography has been reported. However, with the popularity of coronary computerized tomography angiography (CTA), CAFs have been found more and more by chance. The purpose of this study was to determine the prevalence and types of CAFs detected by coronary CTA, and to explore the differences in the size of fistulas, the number of complicated aneurysms, and fistulas among different types. From January 2016 to December 2020, 96,037 patients underwent coronary CTA in our hospital. The prevalence of CAF was retrospectively evaluated, The origin, course, and drainage site of CAF and coexisting abnormalities were analysed. The conventional treatments and follow-up DSCT images were also evaluated. Analyze the difference between the coronary-pulmonary artery fistula (CPAFs) group (380) and the coronary-cameral fistula (CCF) group (99). Among 96,037 patients, 482 (0.5%) patients (male 232 and 250 female) had CAF. The types of CAF detected. The pulmonary artery was the most common site of drainage (380/482, 78.8%). Of the 99 CCFs, coronary to the left ventricle is the most common pattern in CCF (34/482, 7.0%). Single origins are more common in CAF (n = 361, 74.9%), multiple origins are more common in CPAFs than in CCF. There were statistically significant differences in the stoma diameter (2.4 ± 1.1 mm vs. 5.4 ± 4.3 mm p < .05), aneurysm complicated (85 cases [85/380] vs. 50 cases [50/99]), the size of aneurysm (8.8 ± 5.7 mm vs. 19.1 ± 11.6 mm, p < .05), and single fistula (261 [261/380] vs. 96 [96/99], p < .05). Most of the 380 CPAFs patients received conservative treatment (350/380, 92.1%), While the 59 CCF patients (59/93, 63.4%) were treated. Different from previous reports, the prevalence of CAF in coronary CTA is 0.5%, the incidence of CPAFs is the highest, and the incidence of the left ventricular fistula is higher in CCF. Compared with CPAFs, CCF fistulas were more likely to be associated with a larger diameter of draining, larger aneurysms, single fistula pattern. Coronary artery CTA is a useful and noninvasive imaging method to detect CAF, which is of great significance for the detection of small fistulas and the surgical guidance of complex CAF.

A case of coronary artery fistula with multiple coronary artery aneurysms diagnosed by transthoracic echocardiography.

A case of coronary artery fistula with multiple coronary artery aneurysms diagnosed by transthoracic echocardiography.

Atypical Presentation of Coronary Artery Fistula: Case Report and Review of the Literature

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.

A Case of Coronary Artery Fistula to Left Ventricle without Treatment for More 10 Years after Diagnosis

A Case of Coronary Artery Fistula to Left Ventricle without Treatment for More 10 Years after Diagnosis

Coronary Artery Fistulas: Pathophysiology, Imaging Findings, and Management-Erratum.

HomeRadioGraphicsVol. 38, No. 7 Previous ErrataFree AccessCoronary Artery Fistulas: Pathophysiology, Imaging Findings, and Management—ErratumGabin Yun, Tae Hyun Nam, Eun Ju ChunGabin Yun, Tae Hyun Nam, Eun Ju ChunGabin YunTae Hyun NamEun Ju ChunPublished Online:Nov 13 2018https://doi.org/10.1148/rg.2018184013MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Originally published in:RadioGraphics 2018; 38(3):688–703 • https://doi.org/10.1148/rg.2018170158Coronary Artery Fistulas: Pathophysiology, Imaging Findings, and ManagementGabin Yun, Tae Hyun Nam, Eun Ju ChunErratum in:RadioGraphics 2018:38(7):2214 • https://doi.org/10.1148/rg.2018184013Second paragraph, page 690: The first sentence should read as follows: “Transthoracic or transesophageal echocardiography [not ECG] can be used to delineate the anatomy of CAFs and determine hemodynamic changes without the use of ionizing radiation or contrast material.”Table 1, page 691: The heading in the second row, first column, should be “Echocardiography” [not ECG].Article HistoryPublished online: Nov 13 2018Published in print: Nov 2018 FiguresReferencesRelatedDetailsCited ByCTA analysis of 482 cases of coronary artery fistula: A large‐scale imaging studyRenhuiCai, XiaojingMa, XinxiangZhao, JuanXu, LiZhu, LeizhiKu2022 | Journal of Cardiac Surgery, Vol. 37, No. 7Colossal left main to right atrium fistula ligation complicated by left circumflex STEMIGiorgio A.Medranda, ShannonLance, RonWaksman, Nelson L.Bernardo2021 | Catheterization and Cardiovascular Interventions, Vol. 97, No. 6Cardiac-CT with the newest CT scanners: An incoming screening tool for competitive athletes?GiancarloSavino, Francesca LoPiccolo, BiagioMerlino, GiuseppeRovere, MassimilianoBianco, Salvatore FrancescoGervasi, VincenzoPalmieri, Anna RitaLarici, RiccardoManfredi, RiccardoMarano2021 | Clinical Imaging, Vol. 78Coronary artery fistulas detected with coronary CT angiography: a pictorial review of 73 casesNingLi, PengZhao, DaweiWu, ChanghuLiang2020 | The British Journal of Radiology, Vol. 93, No. 1108Accompanying This ArticleCoronary Artery Fistulas: Pathophysiology, Imaging Findings, and ManagementMar 30 2018RadioGraphicsRecommended Articles Adult-type Anomalous Origin of the Left Coronary Artery from the Pulmonary ArteryRadiology2021Volume: 300Issue: 2pp. 287Congenital Coronary Artery–to–Pulmonary Artery Fistula with Anomalous Origin of Right Coronary Artery from Pulmonary Artery: A Case of “Double Trouble”Radiology: Cardiothoracic Imaging2021Volume: 3Issue: 4Anomalous Coronary Arteries That Need Intervention: Review of Pre- and Postoperative Imaging AppearancesRadioGraphics2017Volume: 37Issue: 3pp. 740-757Multimodality Imaging for More Accurate Diagnosis and Risk Assessment in Infective EndocarditisRadiology2020Volume: 297Issue: 2pp. 342-343Coronary Artery Aneurysm in Kawasaki Disease: Coronary CT Angiography through the Lens of Pathophysiology and Differential DiagnosisRadiology: Cardiothoracic Imaging2021Volume: 3Issue: 5See More RSNA Education Exhibits Coronary Artery Termination Variations and AnomaliesDigital Posters2018Assessment of Coronary Artery Fistulas by Computed Tomographic Angiography (CTA)Digital Posters2018MSCTÂ Imaging of Unusual Coronary to Pulmonary Circulation FistulaeDigital Posters2018 RSNA Case Collection Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA)RSNA Case Collection2020Anomalous origin of the right coronary artery from the left sinus of ValsalvaRSNA Case Collection2020Pulmonary AtresiaRSNA Case Collection2022 Vol. 38, No. 7 Metrics Altmetric Score PDF download

A Case of Coronary Artery Fistula Communicated to the Right Atrium with Coronary Aneurysm

A Case of Coronary Artery Fistula Communicated to the Right Atrium with Coronary Aneurysm

Late presentation of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was confused with coronary artery fistula

Anomalous origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) is a rare congenital anomaly, which presents with myocardial ischemia and infarction in children. If left untreated, it carries a high mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic sub-endocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death. We report a case of an 8 years old Saudi female, who was referred to our cardiac center as a case of coronary artery fistula from RCA to RV and referred for possible transcatheter closure and was found to have the anomalous origin of the left coronary artery from the pulmonary artery that was subsequently surgically corrected. The Patient was medically free, asymptomatic apart from on and off palpitations during asthma exacerbations especially after taking Ventolin, she has no history of chest pain, her ECG showed no signs of ischemia, echocardiography showed normal ventricular systolic function which is unusual for ALCAPA cases due to multiple coronary collaterals

Computed Tomography Assessment of Coronary Fistulas

Abstract Coronary artery fistulas, a rare anomaly, are represented by an abnormal communication between the coronary arteries and other vascular structures or cardiac chambers and, in most cases, are detected incidentally. Regularly, they do not cause important pathological changes, but if the symptoms persist, they need to be treated. The hemodynamic impact depends on the localization and size of the fistulas. Noninvasive imaging techniques, such as magnetic resonance imaging and multislice computed tomography, are widely used for the detection of coronary anomalies. The presence of symptoms (angina, dyspnea) is the primary indication for the surgical or percutaneous closure of the communications; therefore, a systematic follow-up is indicated in all cases. We present four cases of coronary artery fistulas, without important hemodynamic complications, detected by multislice computed tomography coronary angiography.

OP-131 [AJC » Percutaneous coronary interventions] Two Interesting Cases of Coronary Artery Fistulas Treated by Coil Embolization

OP-131 [AJC » Percutaneous coronary interventions] Two Interesting Cases of Coronary Artery Fistulas Treated by Coil Embolization

Percutaneous closure of a giant coronary artery fistula after surgical pericardiectomy. Review of the literature.

Coronary artery fistulae (CAF) are uncommon heart defects defined as a communication between a coronary artery and a cardiac chamber or vascular structure. They are frequently asymptomatic; nevertheless, they can produce angina, dyspnea or cardiac failure. CAF are believed to be congenital; however, isolated cases of CAF have been described as rare complications of cardiac surgery. We report the percutaneous closure of a giant CAF in an adult patient with angina and previous pericardiectomy.

Pediatric coronary artery fistula: echocardiographic case reports and literature review of treatment strategy.

BackgroundCoronary artery fistula (CAF) is a rare cardiac anomaly. Application of transthoracic echocardiography (TTE) is not fully illustrated in pediatric period. Meanwhile, the treatment strategy of CAF is still a controversial issue.Case presentationFive cases of CAF with different types were presented. We also retrospectively reviewed 32 records of CAF in our institution from May 2001 to January 2015, including cardiac murmurs, symptoms, TTE diagnoses, complications, other anomalies, treatment and outcome. We summarized the most acceptable treatment strategy for pediatric patients. 71.9 % of all (23/32) had murmurs, 15.6 % of all (5/32) had symptoms. 24 patients received surgery or other imaging examination after TTE. 87.5 % of all (21/24) were correctly and accurately diagnosed by echocardiography, including pointing out the origin and outlet of CAF and complication. During the followup of all 32 patients, there was no spontaneous closure, heart failure, infective endocarditis or death case.ConclusionsTTE is a useful method that should be considered in the investigation and follow up of pediatric coronary artery fistula. The treatment strategy for pediatric patients should be individuation.

Large coronary artery fistula

Summary We present a case of congestive heart failure with pulmonary artery hypertension caused by a left-to-right shunt. Physical examination on admission revealed hypertension, arrhythmia, a diastolic murmur over the bilateral sternal borders, and a pitting edema over both lower legs. Imaging studies revealed a large coronary artery fistula (CAF). After ligation of the fistula, the patient recovered adequately and was discharged. Although cases of CAF have been reported and clinical presentations such as congestive heart failure are not rare, CAFs require particular attention, because they typically exhibit a varied clinical course. We present this case to share our experience regarding myocardial protection and help practitioners prevent misdiagnosis or delayed treatment for such cases.

Right Coronary Artery Fistula and Occlusion Causing Myocardial Infarction after Blunt Chest Trauma

Myocardial infarction (MI) secondary to coronary artery fistula and the subsequent occlusion of the distal right coronary artery (RCA) after blunt chest trauma is a rare entity. Here, we describe a case of coronary artery fistula and occlusion with an inferior MI that occurred following blunt chest trauma. At the initial visit to the emergency room after a car accident, this patient had been undiagnosed with acute myocardial infarction, readmitted five months after ischemic insult, and revealed to have experienced MI due to RCA-right atrial fistula and occlusion of the distal RCA. He underwent coronary surgery and recovered without complications.

A Rare Case of Congenital Coronary Artery Fistula Evaluated by Cardiac MRI

In a patient with coronary artery fistula extending from anterior aortic sinus to postero-superior wall of right atrium, Magnetic Resonance Imaging was able to accurately demonstrate dilatation of the involved coronary artery, the tortuous nature of the dilated fistula, blood flow within the fistula and its communication with right atrium. Coronary artery fistulas are among the rare anomalies of coronary arteries. Role of angiography is well established in identification and characterization of these anomalies, however their accurate course and termination is often not defined. We demonstrate role of cardiovascular MRI in non- invasively diagnosing and characterizing the course of these anomalous coronary branches. Here we report a rare case of coronary artery fistula, symptomatic due to hemodynamically significant coronary steal phenomenon. Magnetic Resonance Imaging revealed abnormal dilated tortuous channel extending from anterior aortic sinus and postero-superior wall of right atrium suggestive of right coronary artery fistula. Large opening of the fistula was repaired with SFD patch and opening of the fistula in right atrium was closed directly with prolene. Nepalese Journal of Radiology / Vol.3 / No.1 / Issue 4 / Jan-June, 2013 / 103-108 DOI: http://dx.doi.org/10.3126/njr.v3i1.8823

症例 気管支動脈・肺動脈吻合を合併した両側冠状動脈・肺動脈異常交通症の1例

症例 気管支動脈・肺動脈吻合を合併した両側冠状動脈・肺動脈異常交通症の1例

Interesting case of coronary artery fistula and coronary anomaly resulting in coronary steal with literature review

Coronary artery fistulae are rare and abnormal communications between a coronary artery and a great vessel, which may shunt blood flow away from the myocardial capillary network causing steal phenomenon. We present a 47-year-old man with a unique arteriovenous fistula originating from the proximal portion of the left main coronary artery and entire left anterior descending artery, which then reconstitutes to form a branch of the left pulmonary artery. Key words: Coronary artery fistula, coronary steal phenomenon, coronary artery anomaly, A-V fistula.

Complications of Endomyocardial Biopsy in Heart Transplant Patients: A Retrospective Study of 2117 Consecutive Procedures

Background Endomyocardial biopsy (EMB) remains the gold standard for the diagnosis of graft rejection after heart transplantation (HT). Our purpose was to evaluate the rate of complications of this invasive procedure. Methods This was a retrospective study of 175 patients, who were transplanted between November 2003 and October 2010 and survived more than 1 month after surgery. We evaluated the number of inconclusive EMB and described the incidence, nature, and subsequent management of several complications associated with this procedure. Results Over a period of approximately 7 years, we performed 2217 EMB yielding 4972 specimens, namely, an average of 2.3 fragments per procedure. The majority of EMBs (95.3%) were performed by the femoral approach. Only 12 EMB (0.57%) were inconclusive. The overall complication rate was 0.71%. During puncture, one patient experienced a vasovagal reaction and another one, a femoral artery false aneurysm. During the biopsy, there was one case of cardiac perforation with tamponade, two cases of supraventricular tachycardia, and three atrioventricular conduction abnormalities. In 19 patients, histological analysis revealed chordal tissue, but only two patients developed mild tricuspid regurgitation. We observed five cases of coronary artery fistulae. The clinical outcomes were favorable in all cases. Conclusion EMB proved to be a suitable, safe method to monitor rejection after HT.

A case of coronary artery fistula diagnosed in the right decubitus position by transthoracic echocardiography

A 70-year-old woman was admitted to our hospital for a continuous heart murmur in the fourth intercostal space at the right sternal border. Routine echocardiography demonstrated aneurismal dilatation at the origin of right coronary artery. These findings suggested a coronary artery fistula, although its drainage site could not be identified. By shifting the patient to the right decubitus position, we could observe an abnormal color Doppler signal going from the right coronary artery into the right atrium, confirming coronary artery fistula. The right decubitus position may be helpful for the evaluation of abnormal anatomic and auscultatory findings.