Fístula coronária

Abelin, Aníbal P.; Sarmento‐Leite, Rogério; Quadros, Alexandre Schaan de; Gottschall, Carlos Antônio Mascia

doi:10.1590/s2179-83972008000200021

Cited by 5 publications

(6 citation statements)

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“…In CAF patients drainage most frequently occurs into the right ventricle because of drainage is generally carried out to low pressure chambers (13). Fistulas terminating in the left ventricle are rare (12).…”

Section: Discussionmentioning

confidence: 99%

Miyokardiyal İskemi Oluşturan ve Sol Ventrikülografiyi Taklit Eden Kalıcı Tebesian Venlerin Ciddi Formu

Karakaş¹,

Tosun²,

Korucuk³

et al. 2021

GenelTipDer

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Coronary artery fistula is a rare congenital anomaly. Thebesian veins are multiple coronary artery microfistula that cominicates coronary arteries and ventricles. Most patients with this anomaly are asymptomatic, but some patients may be symptomatic and have a presentation of myocardial ischemia, thrombosis and embolism, heart failure and arrhythmias. We present a case with exertional dyspnea and angina whose myocardial perfusion scintigraphy demonstrated inferior and apical defect with complete reversibility. Coronary angiography showed no coronary stenosis, but capillary blush draining into the left ventricular cavity through multiple microfistulae from the left anterior descending artery, circumflex artery and right coronary artery mimicking left ventriculography. Because of these small multiple fistulas are managed medically, the patient was discharged on a beta blocker, aspirin and ranolazine therapy. The patient stated a reduction in his symptoms one month later.

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Section: Discussionmentioning

confidence: 99%

Miyokardiyal İskemi Oluşturan ve Sol Ventrikülografiyi Taklit Eden Kalıcı Tebesian Venlerin Ciddi Formu

Karakaş¹,

Tosun²,

Korucuk³

et al. 2021

GenelTipDer

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“…It is a rare congenital disorder ranging from 0.08% to 0.3% of the adult population referred for coronary angiography . Generally, drainage is carried out to low‐pressure chambers …”

Section: Discussionmentioning

confidence: 99%

Persistent Thebesian Vessels Involving the Right and Left Ventricles Leading to Coronary Steal Phenomena and Ischemia

et al. 2013

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We report an extremely rare case of thebesian vein microfistulae to both ventricles. A 65-year-old woman, with no major cardiovascular risk factors, presented with multiple episodes of chest pain. The resting electrocardiogram showed T-wave inversion in leads V(1) -V(4). A Dipyridamole myocardial perfusion imaging revealed large and severe inferior defect with complete reversibility. Coronary angiography showed no coronary artery disease. On contrast injection, an exaggerated capillary blush from the distal portions of the right and left coronary artery systems was seen in both ventricles, mimicking the image of ventriculography. This appearance suggests prominent thebesian vessels, a congenital communication between the coronaries and the two ventricles. The clinical relevance of these myocardial sinusoids is still not well established. Although the majority of these fistulas are small in size and with no clinical significance, they can rarely present with chest pain, cardiac arrhythmia, syncope, myocardial infarction, and/or pulmonary hypertension. These fistulae when excessive can cause significant shunting of blood to the ventricles, leading to coronary steal phenomena and ischemia. This phenomenon is facilitated by the low resistance in these microfistulae as opposed to the higher resistance in the normal coronary circulation. Due to the diffuse nature of these microfistulae, neither surgery nor transcatheter therapy is feasible. This condition can only be managed medically; however, it should be noted that vasodilator agents, such as nitrates, can worsen the coronary steal phenomenon. Our patient was treated with ranolazine with significant improvement in her symptoms, which was not reported previously. Multiple coronary artery microfistulae could be an underestimated condition of angina in patient with normal coronaries.

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“…It has a prevalence of around 0.002% in the population, equally in both sexes, and it accounts for 14% of all coronary artery anomalies. [1][2][3] Approximately 55% of cases of fistulas originate from the right coronary artery (or its branches) and 35% from the left coronary artery. In some cases, both arteries are involved.…”

Section: Introductionmentioning

confidence: 99%

“…In these cases, invasive treatment with surgery or percutaneous closure of the fistula should be considered. 3…”

Section: Introductionmentioning

confidence: 99%

Coronary-cavitary Fistula with Aneurysm in its Path: Case Report of Percutaneous Treatment

Jesus¹,

Correia²,

Silva³

et al. 2023

ABC Imagem Cardiovascular

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Fístula coronária

Cited by 5 publications

References 0 publications

Miyokardiyal İskemi Oluşturan ve Sol Ventrikülografiyi Taklit Eden Kalıcı Tebesian Venlerin Ciddi Formu

Miyokardiyal İskemi Oluşturan ve Sol Ventrikülografiyi Taklit Eden Kalıcı Tebesian Venlerin Ciddi Formu

Persistent Thebesian Vessels Involving the Right and Left Ventricles Leading to Coronary Steal Phenomena and Ischemia

Coronary-cavitary Fistula with Aneurysm in its Path: Case Report of Percutaneous Treatment

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