Giant Coronary Artery Fistula Research Articles

Giant right coronary artery aneurysm and fistula into the coronary sinus.

Giant right coronary artery aneurysm and fistula into the coronary sinus.

Giant right coronary artery aneurysm and fistula into the coronary sinus

Giant right coronary artery aneurysm and fistula into the coronary sinus

Giant coronary artery fistula complicated with coronary artery aneurysm and acute myocardial infarction: a case report

BackgroundCoronary artery fistula (CAF) is an abnormal connection between a coronary artery and either a cardiac chamber or the great vessels. Although most patients are asymptomatic, potential complications such as heart failure, angina pectoris or acute myocardial infarction can be fatal.Case presentationWe present here a 62-year-old man diagnosed with giant coronary artery fistula complicated with gross coronary artery aneurysm and acute myocardial infarction. He underwent intravenous thrombolysis treatment at a local hospital, coronary angiography at a regional hospital and complex surgery at a national centre for cardiovascular disease. The patient had no major adverse cardiac events during the 3-year follow-up.ConclusionEarly diagnosis of CAF patients and an appropriate treatment plan are the key factors for avoiding serious complications. Because of the rare incidence of this disease, it is necessary to discover and discuss management strategies, including medical management, percutaneous interventions or surgical treatment, for a successful outcome.

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.

Giant coronary artery fistula diagnosed in newborn period.

Giant coronary artery fistula diagnosed in newborn period.

A case report on giant coronary artery fistula treatment with Onyx34 combined with spring coil

A case report on giant coronary artery fistula treatment with Onyx34 combined with spring coil

Giant Aneurysmal Left Main Coronary Artery to Right Atrium Fistula. A Case for Surgical Approach

Coronary artery fistula (CAF) is a rare congenital anomaly that can be associated with intracardiac shunts, endocarditis, myocardial infarction, or coronary aneurysms. Recent reports have emphasized the efficacy of early closure either by percutaneous transcatheter or open surgical techniques. The purpose of this article is to review a case of 43 year-old male who presented for repair of a giant aneurysmal left main coronary artery fistula emptying into the right atrium. The giant aneurysm fistula dilatation was maximally measured to be 4.3 cm x 3.5 cm. There was clear left pulmonary vein compression and the giant size raised the question of aneurysm. With its unpredictable nature and patient’s worsening symptoms and physical activity limitation, a direct ligation of fistulous tract was performed. Surgical management was safe treatment and efficacious.

Giant Circumflex Coronary Artery Fistula Draining into the Coronary Sinus

Coronary artery fistulas are rare congenital anomaliesarising from an abnormal direct connection between any coronary arteries and a cardiac chamber, a great vessel or the coronary sinus. In this case report we present a rare case of a giant fistula beetwen the first marginal branch of the circumflex coronary artery and the coronary sinus in a patient symptomatic for dyspnea and palpitation. A selective coronary angiography revealed the presence of a fistula between a coronary artery and the coronary sinus. A contrast-enhanced ECG-gated multi-dector computed tomography confirmed the presence of a giant coronary artery fistula between the first obtuse marginal branch of the circumflex coronary artery and coronary sinus. Due to the rapid progression of the fistula diameter and symptoms, the patient underwent to a surgical closure of the fistula. At six months follow up, the patient was in excellent condition and asymptomatic for dyspnea, palpitation or chest pain. A control contrast-enhanced ECG-gated multi-dector computed tomography showed a complete closure of the fistula without residual shunt.

Angina caused by a giant coronary artery fistula

A 49-year-old woman presented with 3 weeks of exertional chest pain. A trans-esophageal echocardiogram with color Doppler was suggestive of a large coronary artery fistula ∼3.1 × 2.4 cm in size, originating from the left main coronary artery and emptying into the superior …

Cardiac tamponade as a rare complication after giant coronary fistula percutaneous closure

We present the case of an unusual complication after percutaneous closure of a giant coronary artery fis-tula. A 76-year-old man with previous admissions due to right heart failure and previous history of atrial fibrillation under acenocumarol, was admitted to our hospital for new onset of symptoms, characterized by progressive dyspnoea and peripheral edema. Physical examination revealed signs of congestive heart failure and a continuous murmur loudest along the lower sternal border. X-Ray showed cardiomegaly due to right chambers dilatation. Transthoracic echocardiography showed right chambers pressure and volume overload, with right ventricular enlargement and dysfunction, tricuspid annulus dilatation and severe tricuspid regurgitation. Cardiac catheterization showed significant elevation of right atrial pressure, as well as significant step-up of oxygen saturation in this chamber. Coronary angiography revealed the presence of a large fistula between the circumflex coronary artery (CCA) and coronary sinus (CS), with severe dilation of the CCA (maximum diameter20 mm). An Amplatzer? PDA was implanted in a distal elbow of the fistula with initailly good results. Anticoagulant therapy was then reinitiated, and a few days later, the patient developed clinical worsening of heart failure and dyspnoea. Echocardiogram showed significant pericardial effusion. Pleuropericardial window was then made draining a500 cm3 of bloody pericardial effusion. The postoperative outcome was excellent, with symptomatic relief and no signs of heart failure.

Hybrid treatment of a giant coronary artery fistula between the left circumflex coronary artery and the coronary sinus

A 60-year-old woman with dyspnoea and palpitation underwent computed tomography (CT), which showed a coronary artery fistula (CAF) originating from an aneurysmal left circumflex coronary artery (LCx) ( Figure 1A , arrow), draining directly into the coronary sinus ( Figure 1B , arrow) and two obtuse marginal branches arising from the CAF. Transthoracic echocardiography (TTE) showed dilatation …

Platinum reward for theft, or the percutaneous treatment of coronary steal due to a giant coronary artery fistula

CasereportAn 89-year-old sister who presented with angina pec-toris and signs of acute left ventricular failure had ahistory of chronic dyspnoea aggravated a few days priorto admission by orthopnoea and nycturia. Typical chestpain with no radiation had started a few hours beforeadmission. There were no cardiac risk factors and vitalsigns were normal. Physical examination revealed aholo-systolic murmur with axillary radiation, diffusepulmonary rales associated with expiratory wheezingand bilateral inferior hypoventilation. Minimal pe-ripheral oedema was present but no jugular vein dis-tension. Chest X-ray was highly suggestive of acutepulmonary oedema. Laboratory investigations revealedleucocytosis at 32.8 G/l consistent with the patient’shistory of chronic lymphoblastic leukaemia, blood BNPwas elevated at 177 pg/ml and the rest of the initialworkup including cardiac enzymes was normal. TheECG showed atrial fibrillation at 60 bpm, the restbeing unremarkable.The initial transthoracic echocardiography re-vealed both severe mitral and tricuspid regurgitationwith bilateral atrial dilation and pulmonary arteryhypertension estimated at 55 mm Hg. The left ventric-ular ejection fraction was normal. Under medical ther-apy (metoprolol, lisinopril and torasemide), the symp-toms receded and the mitral regurgitation drasticallydiminished. A coronary angiogram was performed torule out an ischaemic origin for the valvular disease.The latter revealed a giant coronary fistula arisingfrom the mid circumflex coronary artery to the rightatrium (fig. 1). A left-to-right shunt was estimated byFick’s method (Qp/Qs 1.6) and the mitral regurgitationwas graded as trivial.It was considered that the symptoms were at leastin part triggered by the coronary fistula. A 6 Fr EBU4.0 guiding catheter was therefore used to selectivelyengage the left main stem. The fistula was cannulated

Successful Surgical Treatment of Giant Main Coronary Artery Fistula Connecting to Right Atrium

Coronary artery fistulas are rare; they are defined as congenital or acquired coronary artery abnormalities in which blood is shunted into a cardiac chamber, great vessel, or other structure, bypassing the myocardial capillary network. We report here on a case of successful surgical treatment of a giant left main coronary artery fistula in a 29-year-old man who presented to our institution with exertional dyspnea. In this report, the different methods of management are also discussed and the indications for the surgical technique are briefly outlined.

Giant Circumflex Coronary Artery Fistula to the Superior Vena Cava in Patient With Multiple Valvular Disease

3 68-year-old man was admitted to our hospital with a history of dyspnea and considerable fatigue with xercise. Transthoracic echocardiography showed severe itral, aortic, and tricuspid regurgitation. The patient nderwent coronary angiography before surgery, which evealed a giant coronary artery fistula arising from the ircumflex artery (Fig 1). A multi-sliced computed tomoraphic scan was performed to delineate the fistula and ocalize its drainage. Three-dimensional reconstruction howed a tortuous course with multiple loops in the ateral wall (Fig 2) that seemed to end in the pulmonary rtery. Intravenous contrast enhancement allowed the ocation of the drainage orifice in the superior vena cava, ear the right atrium. The patient was operated on through a midline ternotomy. On opening the pericardium, the dilated essel (arrow) was seen to course from the lateral wall f the left ventricle through the transverse sinus, and it nished at the superior vena cava (Fig 3). It measured 5 mm in diameter. Cardiopulmonary bypass was stablished (with bi-caval cannulation) after occlusion f the fistula near its drainage. After mitral valve epair, aortic valve replacement, and tricuspid ring nnuloplasty, the superior vena cava was opened and

Imaging techniques for diagnosing a giant coronary artery fistula

A 72-year-old man presented with new onset heart failure. Chest radiography showed marked cardiomegaly and a dense structure contiguous with the left heart border (Fig. 1). Transthoracic echocardiography was unremarkable because of poor echogenicity. Transesophageal echocardiography (TEE) revealed a giant aneurysm located at the posterior side of the left ventricle, near the mitral annulus (Fig. 2). The enlarged circumflex artery flowed towards the left atrial appendage and fed the giant aneurysm. A provisional diagnosis of coronary fistula was made. Coronary angiography (Fig. 3) unequivocally established the diagnosis of a left coronary fistula. However, TEE and coronary angiography failed to determine the drainage site for the fistula. To trace the drainage accurately, computed tomography (CT) angiography was performed, and showed a partially thrombosed giant aneurysm (14 x 9 cm in diameter), fed by the circumflex coronary artery. The site of drainage appeared to be the main coronary vein (Figs. 4 et 5). Taking into consideration the size of the aneurysm and the heart failure, the patient was referred for surgery. The aneurysm was resected and the circumflex artery ligated, without coronary bypass because of the small size of the vessel bed (Figs. 6 et 7). The patient's postoperative course was unremarkable.

Giant congenital left main coronary artery fistula to the superior vena cava in an adult patient with coronary artery disease

Giant congenital left main coronary artery fistula to the superior vena cava in an adult patient with coronary artery disease

Giant Coronary Artery Fistula with Aneurysm and Multiple Openings: A Two‐Dimensional Echocardiographic Evaluation

Giant Coronary Artery Fistula with Aneurysm and Multiple Openings: A Two‐Dimensional Echocardiographic Evaluation

Transcatheter closure of a giant coronary artery fistula with patent duct occluder

冠的动脉管(CAF ) ，先天的心疾病的一种不平常的形式，被在一根冠的动脉和一个心脏的房间或容器之间的反常通讯描绘。这疾病经常在无征状的个人顺便说一下被发现，并且导致心脏的失败，心肌的局部缺血和咽峡炎，易传染的心内膜炎，和心在以后的生命破裂。外科的修理和 transcatheter 闭合在 CAF 的处理有效、安全，但是 CAF 的经皮的管理能排除中部的 sternotomy 并且心肺绕过，并且可以有有 transcatheter embolization 技术的更少的病态，包括 occluders ormicrocoils 的使用。我们用专利管 occluder 向正确的室从左冠的动脉汇报巨大的 CAF 的成功的经皮的闭合。

Giant Congenital Coronary Artery Fistula to Left Brachial Vein Clearly Detected by Multidetector Computed Tomography

Coronary artery fistulas (CAF) are a rare anomaly in which there is communication between a coronary artery and a cardiac chamber or another vascular structure. A giant congenital CAF to the left brachial vein was identified clearly by multidetector computed tomography (MDCT) in an 84-year-old woman who presented with orthopnea and continuous murmur. Electrocardiogram was almost normal, but chest X-ray showed marked cardiomegaly with pulmonary congestion. Transthoracic echocardiography showed that the wall motion of the left ventricle (LV) was normal, but with an abnormal cavity behind the LV. CAF was suspected and coronary angiography revealed that the CAF originated from the right coronary artery (RCA), connected to the giant vessel. However, because the drainage site was not clearly detected, MDCT was performed and it became clear that the CAF originated from the RCA. The left circumflex artery flowed into the giant vessel, and drained to the left brachial vein.

Giant coronary artery fistula complicated by cardiac tamponade

A 30 year old female was admitted to the hospital with cardiogenic shock due to cardiac tamponade. A ruptured giant coronary artery fistula (CAF) originating from the left main coronary artery draining into the right atrium was identified as the cause. In this case report we describe the clinical course with emphasis on diagnostic work-up and imaging.