Coronary-pulmonary Artery Fistula Research Articles

A case of cardiac tamponade caused by the rupture of aneurysm complicated with coronary-pulmonary artery fistula

A case of cardiac tamponade caused by the rupture of aneurysm complicated with coronary-pulmonary artery fistula

心肺停止したものの救命した両側冠動脈肺動脈瘻・冠動脈瘤の1例

心肺停止したものの救命した両側冠動脈肺動脈瘻・冠動脈瘤の1例

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography.

To evaluate the clinical value of dual-source CT (DSCT) coronary angiography in the diagnosis of coronary artery fistula (CAF) in adults. A large cohort of 17,548 patients, who underwent DSCT coronary angiography in our hospital between January 2008 and October 2013, were retrospectively reviewed for CAF. The origin, course and drainage site of CAF and coexisting abnormalities were analysed. The conventional angiography results, treatments and follow-up DSCT images were also evaluated. A total of 33 CAFs from 17,548 patients were detected. The incidence of CAF was 0.19% by DSCT. CAF originating from the left coronary artery (LCA) was found in 14 (42.4%) patients, from right coronary artery (RCA) in 4 (12.1%) cases and from both LCA and RCA in 15 (45.5%) patients. The pulmonary artery was the most common site of drainage (28/33, 84.8%). 8 of the 33 (24.2%) cases were associated with aneurysms. Six cases were associated with coronary artery atherosclerosis. Four patients underwent conventional angiography. Coronary-pulmonary artery fistula in adults was found more often than in previous studies. CAF commonly originates from LCA or both LCA and RCA in adults. DSCT is a robust tool for investigating the origin, course and drainage site of CAF and coexistent abnormalities. A large adult patient cohort who underwent DSCT angiography was reviewed to assess CAFs. Coronary-pulmonary artery fistula in adults was found more often than in previous studies. CAF was observed to originate from the LCA or both coronary arteries in adults. DSCT could clearly depict the fistula origin, course, drainage site and coexisting abnormalities. Conventional angiography results, treatments and follow-up DSCT images were analysed.

A case of adult heterotaxy syndrome accompanied by coronary-pulmonary artery fistula and saccular aneurysm

A case of adult heterotaxy syndrome accompanied by coronary-pulmonary artery fistula and saccular aneurysm

Bilateral coronary artery - pulmonary artery fistula with recurrent ventricular tachycardia: Case report

Bilateral coronary artery fistulae to pulmonary artery with ventricular tachycardia have not yet been described in the literature. A case of a 23-year-old male patient who was treated at our clinic for recurrent ventricular tachycardia is presented. The patient was born with six fingers on his left hand, which was surgically corrected in his early childhood. Perfusion scintigraphy demonstrated reversible ischemia at the irrigation zone of the right coronary artery. The coronary angiography revealed two coronary to pulmonary artery fistulae. The right coronary artery fistula drained through a tubular vessel formation into the pulmonary artery, but the left anterior descendent fistula drained via multiple thin tortuous vessels into the pulmonary artery. The right coronary artery fistula was ligated surgically. The control scintigraphy registered no perfusion defect subsequently, but during the procedure ventricular tachycardia occurred. An electrophysiology study followed, but ventricular tachycardia could not be provoked. Two months later ventricular tachycardia occurred again. Two subsequent electrophysiology studies showed no ventricular tachycardia.The patient was treated with an implantable cardioverter defibrillator.Ventricular tachycardia was terminated four times during the first year follow-up. The mechanism of the ventricular tachycardia was unclear.The electrophysiology study was not sufficiently reliable in the patient with recurrent ventricular tachycardia and bilateral coronary artery to pulmonary artery fistulae. The therapy of choice and the prevention of sudden death in this case was an implantable cardioverter defibrillator.

Coronary-pulmonary artery fistula: Heart-on-a-heart appearance

Coronary-pulmonary artery fistula: Heart-on-a-heart appearance

Left circumflex coronary–pulmonary artery fistula and transmediastinal participation of bronchial arteries best shown by CT

Fistulous communication of the coronary arteries with the pulmonary arteries in adults is a common type of coronary artery fistula [1–3]. In most reported cases, the fistula usually arise from the proximal left and/or right coronary arteries via the anterior conal branches that connect to the anterior wall of the main pulmonary artery. These anteriorly located abnormal communications are usually asymptomatic and are incidentally found during transcatheter or CT angiography (CTA) of the coronary arteries in 0.2–0.3% of studies [1,2].

TCTAP A-135 Coronary-pulmonary Artery Fistula Complicated with Coronary Artery Aneurysm Treated with Transcatheter Coil Embolization

TCTAP A-135 Coronary-pulmonary Artery Fistula Complicated with Coronary Artery Aneurysm Treated with Transcatheter Coil Embolization

Dual-source CT coronary angiographic evaluation of coronary artery fistulas.

The aim of the present study was to retrospectively evaluate the incidence and morphological features of coronary artery fistulas (CAFs) detected by dual-source computed tomography coronary angiography (DS-CTCA). Between January 2011 and January 2013, 19,584 consecutive patients that had undergone electrocardiogram-triggering DS-CTCA were retrospectively reviewed. Image reconstructions were performed and image quality was evaluated. The medical information of the patients with CAF was reviewed from the medical records. Among the 19,584 patients, 66 patients were diagnosed with CAFs by CTCA, including 60 patients with coronary pulmonary artery fistulas (CPAFs) and six with coronary left ventricular fistulas. Therefore, the incidence of CAFs was 0.34%. Image quality was considered to be excellent in 61 patients and moderate in five cases. CPAFs were identified as small and tortuous vessels in 24 patients and dilated vessels close to the surface of the pulmonary artery (PA) in 36 patients. The coronary left ventricular fistulas were identified as dilated vessels that were draining into the posterior wall of the left ventricle. Among the 66 patients, 54 patients had one traceable fistula and the remaining 12 patients were shown to have two fistula vessels. The average diameter of the detected fistulas, measured with CTCA, was 3.1±1.9 mm. A high-density flow jet of contrast agent shunting from the fistula into the low density PA was observed in 46 patients with CPAF. The results indicate that DS-CTCA is a reliable noninvasive tool that allows the accurate delineation of CAFs.

Severe heart failure induced by hypertension combined with right coronary-pulmonary artery fistula: a case report

Severe heart failure induced by hypertension combined with right coronary-pulmonary artery fistula: a case report

Giant coronary-pulmonary fistula with pulmonary atresia, ventricular septal defect, and coronary anomaly: A case report and review of literature

Congenital coronary-pulmonary artery fistula is a rare condition and is usually associated with pulmonary atresia. We present a 10-year-old girl with circumflex coronary artery to pulmonary artery (PA) fistula with a giant dilated circumflex coronary artery, ventricular septal defect (VSD), pulmonary atresia, and anomalous originofleft anterior descending (LAD) artery from right coronary sinus. The patient underwent surgical correction. We report the investigation, treatment, and review of literatureof this rare congenital anomaly associated with dilated circumflex coronary artery.

Functional assessment of a left coronary-pulmonary artery fistula by coronary flow reserve.

We report a 71-year-old man who presented with atypical chest pain. Coronary angiography did not reveal left main or proximal left anterior descending coronary artery stenosis, but a fistulous communication with a stronger tube-like fistula was present originating from the proximal left anterior descending coronary artery and emptying into the main pulmonary artery. Fractional flow reserve and coronary flow reserve measurements were performed to gain more data on the potential functional aspects of this fistula. With the present case, the importance of functional evaluation of these fistulas is demonstrated.

A Coronary–Pulmonary Artery Fistula with Giant Aneurysm in a Child with Ventricular Septal Defect with Pulmonary Atresia

Mini‐AbstractPulmonary atresia with ventricular septal defect accounts for about 2% of all congenital heart diseases. Aortopulmonary collaterals are the usual source of pulmonary blood flow. Coronary–pulmonary artery fistula is a rare and sole source of pulmonary blood flow. We are reporting a case of a 6‐year‐old girl who presented with severe cyanosis, clubbing, and effort intolerance. Echocardiography demonstrated a large subaortic ventricular septal defect and pulmonary atresia with confluent pulmonary arteries. It also revealed the presence of a coronary–pulmonary artery fistula along with a giant coronary artery aneurysm. These findings were confirmed by an aortic root angiogram. She was referred for intra‐ cardiac repair.

Coronary-pulmonary artery fistula in tetralogy of Fallot with pulmonary atresia.

Surgical correction of patients with tetralogy of Fallot with pulmonary atresia is now one of the routine procedures performed by pediatric cardiac surgeons. In one variant, the pulmonary arterial supply is derived from a fistulous communication from the coronary arteries. This rare and interesting situation poses a diagnostic and therapeutic dilemma, as well as providing specific management challenges to the surgical team. Here, we discuss important aspects of this rare variant, specifically its morphology, presentation, evaluation and management.

A Unique Case of Quadricuspid Aortic Valve With Coronary Artery and Descending Aorta-to-Pulmonary Artery Fistulae

46-year-old man with well-controlled hypertension pre-sented with dyspnea, palpitations, and a murmur of aortic regurgitation. Echocardiography revealed a quadricuspid aortic valve (QAV) with 4 equal-sized cusps and enlarged left main coronary artery ostium (Figure 1A). On additional imaging, an unusual flow was seen entering the proximal main pulmonary artery from the lateral aspect just distal to the pulmonic valve (Figure 2A and Movie I in the online-only Data Supplement). A QAV with moderate aortic regurgitation (Movie II in the online-only Data Supplement) and a coronary-pulmonary artery fistula were diagnosed by echocardiography. Computed tomography confirmed the presence of QAV (Figure 1B) and a small-cal-iber vessel that originated from the left main coronary artery, coursed superiorly (Figure None.2B), and ended in a larger confluence of anomalous vessels that communicated with the pulmonary artery (Figure 2C). Other vessels contributing to this conflu-ence originated from the descending aorta and followed a very tortuous course (Figure 2D1 through 2D3). A 3-dimensional reconstruction shown in Figure 2E demonstrates the descend-ing aorta-to-pulmonary artery fistula and coronary artery-to-pulmonary artery fistula draining into a large confluence. Thus, a unique anomaly in combination with QAV was diagnosed.QAV is a rare malformation, with an estimated incidence of 0.003% to 0.043% of all congenital heart disease.

Double congenital fistulae with aneurysm diagnosed by combining imaging modalities.

Congenital coronary pulmonary artery fistula (CAF) is rare, and systemic-to-pulmonary artery fistula (SPAF) is even more so. Furthermore, congenital coronary pulmonary fistula associated with congenital SPAF is extremely rare. As far as we know, CAF and SPAF connected with an aneurysm have not been described very often. We described an 83-year-old woman with an aneurysm originating from a CAF connected to an aortopulmonary artery fistula. Chest radiography revealed a shadow at the left edge of the heart line. Multi-detector-row computed tomography (MDCT) with contrast enhancement and coronary cine angiography revealed that the shadow was an aneurysm connected to a tortuous fistula at the left anterior descending coronary artery. The aneurysm was formed by congenital coronary pulmonary and aortopulmonary artery fistulae. Echocardiography revealed predominantly systolic blood flow in the fistula from the left anterior descending coronary artery (LAD). Although neither MDCT, echocardiography nor coronary angiography alone could provide a comprehensive image of the anomaly, including the hemodynamics in the fistulae and their relationship with surrounding organs and tissues, their combination could provided important facts the led to a deeper understanding of this very uncommon occurrence.

Coronary Artery and Pulmonary Artery Fistula Originated from Significant Stenosis in the Left Anterior Descending Artery

Coronary artery fistula (CAF) is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD) stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA). CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment options.

An Extremely Large Coronary Aneurysm Associated with a Quadricuspid Aortic Valve in an Adult Patient

A 68-year-old woman exhibited an increasingly protruding mass on the left heart border on chest X-ray. Transthoracic echocardiography revealed an echo-free mass in the anterior pericardial space. Transesophageal echocardiography revealed blood flow from the proximal left anterior descending coronary into a large coronary artery aneurysm measuring 61 mm × 51 mm in diameter and a quadricuspid aortic valve with a small cusp between the left and right coronary cusps. Coronary angiography demonstrated the presence of a coronary aneurysm connected to the proximal left coronary anterior descending artery. A giant coronary artery aneurysm and pulmonary artery fistulas extending from the left and right coronary arteries were confirmed by surgeons and successfully treated with surgery.

A surgically treatment case of coronary-pulmonary arterial fistula with aortic regurgitation

A surgically treatment case of coronary-pulmonary arterial fistula with aortic regurgitation

Coronary-pulmonary artery fistula accompanied by an aneurysm, detected by chest X-ray at routine health check

Coronary-pulmonary artery fistula accompanied by an aneurysm, detected by chest X-ray at routine health check