Ventricular Fistula Research Articles

Chest distress in a young adult due to simultaneous occurrence of single left coronary artery anomaly and coronary-left ventricular fistula

a Magnetic Resonance Center, The Affiliated Zhongshan Hospital of Xiamen University, Xiamen, China b Institute of VascularMedicine, Institute of Innovative Medicine, Heart Education and Research Training (HEART) Center, Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong c Department of Ultrasound, The Affiliated Zhongshan Hospital of Xiamen University, Xiamen, China d Department of Gastrointestinal Surgery, The Affiliated Zhongshan Hospital of Xiamen University, Xiamen, China

Left Main Coronary Artery Arising From the Right Sinus of Valsalva in a Patient with Apical Hypertrophic Cardiomyopathy

Coexistence of left main caronary artery emerging from the right sinus of Valsalva with Coronary artery-left ventricular fistulae and apical hypertrophic cardiomyopathy in the same patient has not been reported before. An apparently healthy 55-year-old male was referred for evaluation of atypical chest pain. Electrocardiography, computed tomography angiography and echocardiography confirmed the diagnosis of apical hypertrophic cardiomyopathy. Coronary angiography and computed tomography angiography demonstrated left main coronary artery arising from the right sinus, with left main coronary artery taking a course anterior to the pulmonary artery. The patient received treatment using a calcium channel blocker and stayed asymptomatic until the end of six months of follow-up.

Acute aortic dissection complicated by aorto-right ventricular fistula

Acute aortic dissection complicated by aorto-right ventricular fistula

Acute aortic dissection complicated by aorto-right ventricular fistula

Fistula A 68-year-old man with a history of systemic hypertension and chronic renal failure was admitted to our emergency department with chest pain and dyspnea. He had undergone tube graft replacement of the ascending aorta due to an acute type A aortic dissection 10 years previously. On admission he was hypertensive and tachycardic with a continuous murmur at the left upper sternal border. The electrocardiogram revealed nonspecific repolarization abnormalities and the transthoracic echocardiogram showed a severely dilated aortic root with an intimal flap and continuous turbulent flow from the aortic root toward the right ventricle (Figures 1 and 2). There was moderate aortic regurgitation caused by poor leaflet coaptation. The right chambers were slightly dilated and both ventricles had normal systolic function. Chest computed tomography confirmed aortic root dissection with a fistula between the aortic false lumen and right ventricle (Figures 3 and 4). The coronary arteries were

Coronary steal phenomenon from a coronary artery to left ventricular fistula

An 83-year-old female with well-controlled hypertension presented with gradually worsening dyspnoea on exertion. An exercise stress echocardiogram showed left ventricular hypertrophy with high-risk features for ischaemia at peak stress. Her left ventricular (LV) ejection fraction (LVEF) deteriorated from 65% at rest to 40% post-exercise, despite a submaximal stress test, …

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.

Coronary fistula with ventricular septal defect following chest trauma

We report on a 51-year-old male who developed traumatic ventricular septal defect and coronary artery fistula after an industrial accident involving injury to his chest. The defects were initially haemodynamically non-significant but he progressively developed symptoms of heart failure with associated dilatation of left atrium and ventricle. The ventricular septal defect was diagnosed by echocardiography and the coronary artery fistula was identified by pre-operative angiography. Both defects were surgically repaired more than one year after the injury. A large muscular ventricular septal defect was patched and the coronary artery fistula was closed from within the right ventricle.

Transcatheter coil embolization of a coronary artery-left ventricular fistula associated with single coronary artery anomaly.

Single coronary artery anomaly associated with coronary fistula is a rare entity. Transcatheter coil embolization is the treatment of choice for coronary artery fistulas. In this case report, we describe a patient with both single coronary artery anomaly and coronary fistula who was successfully treated with coil embolization.

大動脈-右室交通を合併した感染性心内膜炎に対し大動脈基部置換術およびパッチ閉鎖術を施行した1例

大動脈-右室交通を合併した感染性心内膜炎に対し大動脈基部置換術およびパッチ閉鎖術を施行した1例

Hypertrophic cardiomyopathy associated with left ventricular noncompaction cardiomyopathy and coronary fistulae – A case report. One genotype, three phenotypes?

The authors present a rare case of hypertrophic cardiomyopathy associated with left ventricular noncompaction cardiomyopathy and coronary artery-left ventricular fistulae in a 42-year-old woman presenting with non-ST-elevation myocardial infarction. Coronary angiography, transthoracic echocardiography and cardiac magnetic resonance revealed the structural abnormalities of the left ventricle and the coronary tree.

Miocardiopatia hipertrófica associada a ventrículo esquerdo não compactado e fístulas coronárias – a propósito de um caso clínico. Um genótipo, três fenótipos?

The authors present a rare case of hypertrophic cardiomyopathy associated with left ventricular noncompaction cardiomyopathy and coronary artery-left ventricular fistulae in a 42-year-old woman presenting with non-ST-elevation myocardial infarction. Coronary angiography, transthoracic echocardiography and cardiac magnetic resonance revealed the structural abnormalities of the left ventricle and the coronary tree.

Left ventricular noncompaction cardiomyopathy: updated review

The first case of noncompaction was described in 1932 after an autopsy performed on a newborn infant with aortic atresia/coronary-ventricular fistula. Isolated noncompaction cardiomyopathy was first described in 1984. A review on selected/relevant medical literature was conducted using Pubmed from 1984 to 2013 and the pathogenesis, clinical features, and management are discussed. Left ventricular noncompaction (LVNC) is a relatively rare congenital condition that results from arrest of the normal compaction process of the myocardium during fetal development. LVNC shows variability in its genetic pattern, pathophysiologic findings, and clinical presentations. The genetic heterogeneity, phenotypical overlap, and variety in clinical presentation raised the suspicion that LVNC might just be a morphological variant of other cardiomyopathies, but the American Heart Association classifies LVNC as a primary genetic cardiomyopathy. The familiar type is common and follows a X-linked, autosomal-dominant, or mitochondrial-inheritance pattern (in children). LVNC can occur in isolation or coexist with other cardiac and/or systemic anomalies. The clinical presentations are variable ranging from asymptomatic patients to patients who develop ventricular arrhythmias, thromboembolism, heart failure, and sudden cardiac death. Increased awareness over the last 25 years and improvements in technology have increased the identification of this illness and improved the clinical outcome and prognosis. LVNC is commonly diagnosed by echocardiography. Other useful diagnostic techniques for LVNC include cardiac magnetic resonance imaging, computerized tomography, and left ventriculography. Management is symptom based and patients with symptoms have a poorer prognosis. LVNC is a genetically heterogeneous disorder which can be associated with other anomalies. Making the correct diagnosis is important because of the possible associations and the need for long-term management and screening of living relatives.

Repair of Aorto-Left Ventricular and Aorto-Right Ventricular Fistulas Following Prosthetic Valve Endocarditis

We report a case of a 77-year-old male who presented with an aorto-left ventricular fistula and an aorto-right ventricular fistula secondary to prosthetic valve endocarditis.

Undetected Aorto-RV Fistula With Aortic Valve Injury and Delayed Cardiac Tamponade following a Chest Stab Wound: A Case Report

IntroductionAlthough a few patients will survive after penetrating cardiac injuries, some of them may have unnoticeable intracardiac injuries. The combination of aorto-right ventricular fistula with aortic valve injury is rare.Case PresentationA 19 year-old man referred with an aorto-right ventricular fistula accompanied with aortic regurgitation and delayed tamponade following a stab in the chest. The patient was scheduled for fistula repair, aortic valve replacement and pericardectomy two months after trauma.ConclusionsTo prevent missing intracardiac injury and also late cardiac injury complications, in all pericordial stab wounds, serial clinical examinations and serial echocardiography should be performed. In addition, cardiac injuries should be repaired during the same hospital stay.

A single coronary artery with a right ventricular fistula

A single coronary artery with a right ventricular fistula

“Wedge effect” in stenosed coronary artery assessed using a PressureWire

In this case report, we describe the recovery of abnormal coronary pressure waveform using a PressureWire Certus during percutaneous coronary intervention in a patient with severe stenosis in the proximal segment of the left anterior descending coronary artery. Since the diastolic pressure in the distal left anterior descending coronary artery was lower than that in the aorta, the pressure waveform before percutaneous coronary intervention represented the left ventricular pressure through a fistula due to a "wedge effect" in the stenosis as if the pulmonary artery wedge pressure determined by a Swan-Ganz catheter reflected the pressure in the distal portion (left atrium). We diagnosed this case coronary artery-left ventricular fistula based on the above findings. PressureWire Certus may be a valuable tool with which to estimate the hemodynamics in a patient with a coronary anomaly.

Spontaneous resolution of iatrogenic coronary artery to right ventricular fistula secondary to percutaneous coronary intervention

Spontaneous resolution of iatrogenic coronary artery to right ventricular fistula secondary to percutaneous coronary intervention

症例 Dressler症候群の経過中に左冠動脈-右室瘻が認められた1例

症例 Dressler症候群の経過中に左冠動脈-右室瘻が認められた1例

EComment. Fistulous complications of acute dissection of the ascending aorta

We read the article by Pagni et al. [1] with great interest. The authors have documented a case of aorto-right atrial fistulization after type A aortic dissection well. We think that the discussion should be primarily focused on fistulous complications of acute ascending aortic dissection, occurring after previous cardiac or aortic surgery. Acute dissection of the ascending aorta is a life-threatening pathology and may lead to serious complications. They include rupture to neighbouring structures, aortic insufficiency, haemothorax, haemopericardium, and occlusion of the major vessels originating from the aorta [2-5]. These complications may occur as the false lumen enlarges. Free rupture of aortic dissection into the pleural and pericardial spaces often results in sudden cardiovascular collapse and death. Fistulization to the cardiac chambers (right atrium, left atrium, and right ventricle) and the pulmonary artery is a rare and often fatal occurrence [2-5]. Fistulous complications can be explained by considering the anatomy of the aortic root. Aortopulmonary, aorta-right atrial, and aorta-right ventricular fistulas produce a left-to-right shunt and congestive heart failure. Pagni et al. [1] have reported a right-to-left shunt depending on the patent foramen ovale. Fistulous complications of aortic dissection may occur in any patient, especially in those with a history of previous cardiac or aortic surgery [2-5]. The incidence of fistulous formation tends to increase with redo surgery. Postoperative adhesions may play an important role in the pathogenetic mechanism of the fistula. In such patients, the dense adhesions probably restrain the free rupture and contribute to the fistulous occurrence. Undoubtedly, prompt diagnosis and early surgical repair of the dissection and fistula would provide for an excellent outcome. In such complicated situations, we think that one should use all the information and imaging techniques available to provide a timely diagnosis and treatment. Conflict of interest: none declared.

A Case of Prune Belly Syndrome

Prune belly syndrome (PBS) is a rare congenital disorder characterized by deficient abdominal wall muscles, urinary tract malformation, and, in males, cryptorchidism. We present a case of PBS in China. The patient was a newborn baby boy who had wrinkled, "prune-like" abdominal skin, bilateral cryptorchidism, and urinary system malformation, complicated with hypoplasia of the lung and branch of the coronary artery-right ventricular fistula. His kidney function was inadequate. The patient subsequently died at age 28 days due to septicemia from a severe urinary tract infection.