A 56-year-old man who had twice previously undergone orthotopic heart
transplantation was admitted with dyspnea and heart failure symptoms. A biopsy
excluded rejection. Left heart catheterization revealed a coronary cameral
fistula. After the patient was given mild diuretics, his condition improved. No
significant fistula flow was detected, and he was discharged. Several months
later, the patient was readmitted with worsening chest pain and dyspnea. Left
ventricular end-diastolic pressure and flow through the fistula were increased.
To correct the coronary cameral fistula, we performed a coil embolization
without complications. Several months later at follow-up, the patient’s symptoms
had resolved, and his left ventricular end-diastolic pressure had normalized. We
conclude that coronary fistulas may be caused by trauma to the heart during the
de-airing process, which may be prevented in the future with the development of
safer and more effective de-airing techniques.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.