Single coronary artery with coronary-pulmonary artery fistula: A case report

Multimodality vascular imaging in sequential treatment for giant coronary artery aneurysms with coronary-pulmonary artery fistulas.

Multimodality Imaging of Coronary-Pulmonary Artery Fistula After Heart Transplantation.

We report a case of a 77-year-old woman with an aneurysmal coronary-pulmonary artery fistula, which was incidentally identified on contrast-enhanced computed tomography. To prevent rupture and other potential complications, surgical repair was indicated. The procedure was performed via bilateral minithoracotomy, providing sufficient exposure while minimizing invasiveness. The aneurysmal segment was successfully excluded without intra-operative complications. Post-operative contrast-enhanced computed tomography confirmed complete exclusion of the lesion with no residual opacification. The patient's recovery was uneventful. This video tutorial demonstrates the step-by-step surgical technique used in this case, highlighting key considerations in exposure, fistula identification and closure. A bilateral minimally invasive approach may be a safe and effective option for selected patients with aneurysmal coronary-pulmonary artery fistulae, especially when conventional sternotomy is not desirable. This case adds to the limited literature on minimally invasive treatment of this rare condition and may assist surgeons in planning similar procedures.

Giant Coronary Artery Aneurysm Originated From the Vieussens Arterial Ring Associated With Coronary-Pulmonary Artery Fistula.

Rare spontaneous closure of a coronary pulmonary artery fistula: a case report

A Surgical Case of Coronary Pulmonary Artery Fistula with Direct Measurement of the Shunt Flow

Coronary artery venous fistulas (CAVFs) are rare congenital anomalies often detected incidentally during routine coronary angiography. While asymptomatic CAVFs are usually managed conservatively due to their potential to regress or close spontaneously, symptomatic CAVFs require intervention. This report presents the case of a 67-year-old female patient with a history of hypertension, type 2 diabetes, and hypercholesterolemia, who presented with chest pain and exertional dyspnea. Routine angiography revealed bilateral CAVFs with fistulas originating from both the left and right coronary arteries, in addition to critical stenoses in the left anterior descending artery and the circumflex artery. The patient underwent CAVFs closure surgery combined with coronary artery bypass grafting (CABG). Postoperatively, all cardiac symptoms were completely resolved. This case highlights that CAVFs should also be considered as a rare cause of ischemic heart disease and demonstrates the effectiveness of surgical intervention in the treatment of symptomatic cases.

We report a rare case of Vieussens’ arterial ring to main pulmonary artery fistula in patient with chest pain who underwent computed tomography (CT) coronary angiography. This case highlights a rare type of coronary-pulmonary artery fistula and role of CT angiography in detecting such anomalies which carry important hemodynamic implications. It is imperative to treat such complicated cardiovascular anomalies to avoid possible long-term clinical consequences.

Cinematic Rendering of a Coronary-Pulmonary Artery Fistula.

A 46-year-old male patient was referred to our hospital due to the presence of a coronary aneurysm showing a tendency to enlarge. Subsequent coronary angiography revealed a diagnosis of coronary aneurysm with a concomitant coronary-pulmonary artery fistula. The patient underwent a successful surgical repair, and postoperatively, experienced an uneventful recovery with no residual shunt or aneurysm.

Fluoroscopy integration module guides successful ablation in atrial fibrillation with coronary-pulmonary artery fistula

Coronary-pulmonary artery fistula with aneurysm formations.

This case report presents a 34-year-old male with Ehlers–Danlos syndrome, type 2 diabetes mellitus, aortic valve regurgitation, and aortic bulb aneurysm. Following spine surgery for thoracic–lumbar stabilization, the patient underwent assessment for aortic bulb aneurysm and aortic valve replacement surgeries. Five months post spinal surgery, a coronary computed tomography angiography was performed. The coronary computed tomography angiography revealed unique findings, including the absence of the left main coronary artery, right coronary artery dominance, ectopic origin of the left circumflex artery from the right sinus of the valsalva, a coronary–pulmonary arterial fistula originating from the right sinus of the valsalva, and an additional right pulmonary vein. The patient was qualified for surgical treatment for an aortic bulb aneurysm, was informed about the high surgical risk, and is awaiting surgery. This case underscores the rarity of Ehlers–Danlos syndrome coexisting with multiple coronary artery anomalies. The presence of a coronary–pulmonary arterial fistula further emphasizes the need for specialized patient monitoring when Ehlers–Danlos syndrome and coronary anomalies converge.

Multiple Giant Coronary Artery Aneurysms with Coronary-Pulmonary Artery Fistula

Objectives: To analyze the reasons of missed diagnosis or misdiagnosis on anomalous origin of left coronary artery from pulmonary artery (ALCAPA) by echocardiography. Methods: This is a retrospective study. Patients with ALCAPA who underwent surgical treatment in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2008 to December 2021 were included. According to the results of preoperative echocardiography and surgical diagnosis, the patients were divided into confirmed group or missed diagnosis/misdiagnosis group. The results of preoperative echocardiography were collected, and the specific echocardiographic signs were analyzed. According to the experience of the doctors, the echocardiographic signs were divided into four types, namely clear displayed, vague/doubtful displayed, no display and no notice, and the display rate of each sign was calculated (display rate=number of clearly displayed cases/total number of cases×100%). By referring the surgical data, we analyzed and recorded the pathological anatomy and pathophysiological characteristics of the patients, and the rate of missed diagnosis/misdiagnosis of echocardiography in patients with different characteristics was compared. Results: A total of 21 patients were enrolled, including 11 males, aged 1.8 (0.8, 12.3) years (range 1 month to 47 years). Except for one patient with anomalous origin of left anterior descending artery, the others were all originated from the main left coronary artery (LCA). There were 13 cases of ALCAPA in infant and children, and 8 cases of adult ALCAPA. There were 15 cases in the confirmed group (diagnostic accuracy was 71.4% (15/21)), and 6 cases in the missed diagnosis/misdiagnosis group (three cases were misdiagnosed as primary endocardial fibroelastosis, two cases were misdiagnosed as coronary-pulmonary artery fistula; and one case was missed diagnosis). The working years of the physicians in the confirmed group were longer than those in the missed diagnosis/misdiagnosed group ((12.8±5.6) years vs. (8.3±4.7) years, P=0.045). In infants with ALCAPA, the detection rate of LCA-pulmonary shunt (8/10 vs. 0, P=0.035) and coronary collateral circulation (7/10 vs. 0, P=0.042) in confirmed group was higher than that in missed diagnosis/misdiagnosed group. In adult ALCAPA patients, the detection rate of LCA-pulmonary artery shunt was higher in confirmed group than that in missed diagnosis/misdiagnosed group (4/5 vs. 0, P=0.021). The missed diagnosis/misdiagnosis rate of adult type was higher than that of infant type (3/8 vs. 3/13, P=0.410). The rate of missed diagnosis/misdiagnosis was higher in patients with abnormal origin of branches than that of abnormal origin of main trunk (1/1 vs. 5/21, P=0.028). The rate of missed diagnosis/misdiagnosis in patients with LCA running between the main and pulmonary arteries was higher than that distant from the main pulmonary artery septum (4/7 vs. 2/14, P=0.064). The rate of missed diagnosis/misdiagnosis in patients with severe pulmonary hypertension was higher than that in patients without severe pulmonary hypertension (2/3 vs. 4/18, P=0.184). The reasons with an echocardiography missed diagnosis/misdiagnosis rate of≥50% included that (1) the proximal segment of LCA ran between the main and pulmonary arteries; (2) abnormal opening of LCA at the right posterior part of the pulmonary artery; (3) abnormal origin of LCA branches; (4) complicated with severe pulmonary hypertension. Conclusions: Echocardiography physicians' knowledge of ALCAPA and diagnostic vigilance are critical to the accuracy of diagnosis. Attention should be paid to the pediatric cases with no obvious precipitating factors of left ventricular enlargement, regardless of whether the left ventricular function is normal or not, the origin of coronary artery should be routinely explored.

Coronary-Pulmonary Artery Fistula as Cause of Acute Coronary Syndrome

Surgical Case of Coronary-Pulmonary Arterial Fistula with Giant Coronary Artery Aneurysm

PULMONARY AND CORONARIES OF THE HEART SHOULD STAY APART: A CASE OF MULTIPLE CORONARY TO PULMONARY ARTERY FISTULAS

Pulmonary trunk compression due to multiple aneurysms associated with a coronary-pulmonary artery fistula.