Left Circumflex Coronary Artery Fistula Research Articles

Outcomes of Transcatheter Closure of Congenital Left Circumflex Coronary Artery Fistula.

Congenital left circumflex coronary artery fistula (LCX-CAF) is a relatively rare type of coronary artery fistula (CAF); little is known about the outcomes of transcatheter closure (TCC) of LCX-CAF.Methods and Results: All consecutive patients admitted to Fuwai Hospital and scheduled for TCC of LCX-CAF between January 2012 and December 2022 were reviewed retrospectively. Of the 25 consecutive patients (mean [±SD] age 34±20 years; 48% male) admitted and scheduled for TCC of congenital LCX-CAF, the procedure was feasible in 22 (77.3%). The mean (±SD) diameter of the fistulas was 6.99±2.04 mm; 21 (84%) patients had a large fistula (i.e., diameter >2-fold greater than non-feeding coronary artery). Occluders were deployed via a transarterial approach and arteriovenous loop in 6 (27.3%) and 16 (72.7%) patients, respectively. No procedural complications were recorded. Although the procedural success rates are similar for single LCX-CAF and left anterior descending CAF (81.25% vs. 92.86%; P=0.602), the mean time from initial angiography to first occluder deployment is significantly longer for LCX-CAF (83.06±36.07 vs. 36.00±9.49 min; P<0.001). The mean (±SD) follow-up time was 62.2±45.5 months. The incidence of myocardial infarction and recanalization of the fistula was 4.5% (1/22) and 9.1% (2/22), respectively. TCC of LCX-CAF is a feasible and effective alternative to surgical repair, with comparable outcomes in selected patients. Optimal medical therapy to prevent post-closure myocardial infarction requires further investigation.

Successful percutaneous occlusion of a large left circumflex coronary artery fistula draining into the coronary sinus using a ventricular septal defect occluder: a case report

BackgroundCoronary artery fistula (CAF) is a congenital anomaly of the coronaries that can lead to significant intracardiac shunting and myocardial ischaemia.Case summaryWe describe the case of a 15-year-old male with an incidentally documented precordial cardiac murmur. An evidently dilated coronary sinus (CS) on transthoracic echocardiography prompted further investigation. A computed tomography (CT) revealed the presence of a large CAF from the left circumflex coronary artery to the CS. No other structural heart defects were detected. A haemodynamically significant intracardiac shunt was confirmed during cardiac catheterization, and it was decided to close the fistula. This was successfully performed using a ventricular septal defect (VSD) occluder (Konar 10-8, Lifetech Scientific) that was deployed through a 6 Fr right coronary guiding catheter. A partial thrombotic occlusion of the CS behind the closure device was noted during follow-up which led to anticoagulation in a higher target INR range and concomitant start of low dose carbasalate calcium to reduce further retrograde thrombus extension. Patient is doing well at over 1 year of follow-up, and no further thrombotic extension into the CS was seen on a recent CT.DiscussionThis report illustrates the diagnostic workup and a percutaneous treatment strategy of a CAF using a VSD occluder. We also describe a not previously reported complication, thrombotic CS occlusion. Improving transcatheter techniques and marketing of novel devices with a broad spectrum of applications can offer new opportunities for treating CAF and avoiding surgical correction often involving cardiopulmonary bypass, reserving this option for patients with complex anatomy or failed transcatheter closure.

Surgical management of a rare circumflex coronary artery fistula draining into the coronary sinus

Coronary artery fistula (CAF) is a rare anomalous connection between a coronary artery and a cardiac chamber or a major vessel. The majority arise from the right coronary artery and drain into the right heart structures. In this report, we present a rare case of a left circumflex coronary artery fistula draining into the coronary sinus managed successfully with surgical intervention.

A Rare Combination of the Left Circumflex Coronary Artery Fistula Connecting a Dilated Coronary Sinus with Persistent Left Superior Vena Cava and Multiple Arteriovenous Fistulae

Coronary artery fistula (CAF) is an abnormal communication between an epicardial coronary artery and a cardiac chamber, major vessel or other vascular structures. This report presents a rare case of CAF in which a dilated left main trunk and proximal circumflex coronary artery are connected to a dilated coronary sinus. There were also two other fistulae and persistent left superior vena cava. The coronary fistula was managed conservatively.

Left Circumflex Coronary Artery Fistula Connected to the Right Bronchial Artery Associated with Bronchiectasis: Multidetector CT and Coronary Angiography Findings

Left Circumflex Coronary Artery Fistula Connected to the Right Bronchial Artery Associated with Bronchiectasis: Multidetector CT and Coronary Angiography Findings

Transcatheter Closure of a Left Circumflex Coronary Artery Fistula in Two Children Using the Amplatzer Vascular Plug

A left circumflex coronary artery fistula (CAF) is a rare anomaly. This report describes two young children with progressive left coronary artery dilation due to left CAF demonstrated by serial echocardiography. Cardiac catheterization performed for both children confirmed the presence of a markedly tortuous and dilated left circumflex artery, with the CAF draining directly into the right ventricle. Transcatheter closure of the CAF using the Amplatzer vascular plug was successfully accomplished without any complications. A good outcome was achieved. The echocardiography at the 12- and 18-month follow-up visits showed reversion of the coronary artery to normal size.

Rare coronary artery anomaly: left circumflex coronary artery fistula draining into the pulmonary artery

Rare coronary artery anomaly: left circumflex coronary artery fistula draining into the pulmonary artery

Diagnosis of the left circumflex coronary artery fistula drainage into the left ventricle by echocardiographic color Doppler flow imaging

Congenital coronary fistula is consisted of a communication between a coronary artery and a cardiac chamber or pulmonary vessel. Congenital left coronary artery–left ventricle fistula is uncommon. A 41-year-old female patient admitted to our institution for evaluation of heart murmur etiology. A loud continuous murmur heard at the apex area was detected at auscultation. Echocardiography showed a large fistula draining into the left ventricle apex. Coronary angiography revealed fistula from left circumflex coronary artery to left ventricular cavity. Since the patient was asymptomatic and no concomitant cardiac pathology was detected, we advised endocarditis prophylaxis and medical follow-up.

Left circumflex coronary artery fistula to the superior vena cava: assessment of the exact anatomy by multidetector CT

A 62-year-old woman with mild dyspnea on exertion underwent coronary angiography. A large fistula of the left circumflex artery was found but the exit site of this unusual anomaly could not be established. Contrast-enhanced multidetector computed tomography of the coronary arteries was performed which allowed clear identification of the drainage of the fistula into the superior vena cava.

Coronary artery fistula causing heart failure in a newborn: successful surgical management.

• A 5-day-old infant had severe heart failure because of a large left circumflex coronary artery fistula entering the right atrium. Oximetry and angiography demonstrated a large left to right shunt, and surgical ligation of the fistula provided rapid relief of symptoms. ( Am J Dis Child 1982;136:530-532)