Communicating bilateral coronary artery to pulmonary artery fistula with aneurysms

Jung, Hoon Sik; Lee, Tae Kun; Bae, WooHyeong; Yun, Chi Sun; Park, Chung Hun; Jang, Jin Bae

doi:10.1016/j.ijcard.2009.03.132

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Approximately, 40% were managed conservatively, 27% has coil embolization, 27% had surgical treatment, and 13% had catheter-mediated occlusion of the fistula. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Dodge-Khatami et al 17 have classified CAFs as follows:…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of Coronary Artery Fistulas: Clinical Aspects and Brief Review of the Literature

2013

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An 86-year-old woman with a history of hypertension, diabetes, coronary artery disease, and arrhythmias was presented to the emergency department with a productive malaise, fever, worsening shortness of breath, and diaphoresis. The patient was normotensive, tachycardic, hypoxic, with regular heart sounds without associated murmur with clinical evidence of congestive heart failure (distension of jugular veins and bilateral basal lung crackles).A 12-lead electrocardiogram revealed sinus tachycardia with a heart rate of 124 beats per minute with new T-wave inversions in lead aVL, and ST depressions in leads V5 and V6. Beta natriuretic peptide was 546 pg/mL. Chest X-ray demonstrated diffuse pulmonary edema.The patient initially was placed on a nitroglycerin drip; however, her blood pressure dropped substantially, and therefore, this medication had to be discontinued. The patient also received nebulizer treatments and oxygen that resulted in improvement of her clinical condition. She was admitted for management of congestive heart failure and pneumonia. She was started on medical treatment of pneumonia (Levofloxacin, Sagent Pharmaceuticals, Schaumburg, IL) and congestive heart failure (furosemide, β-blockers, and angiotensin-converting enzyme inhibitor). Echocardiogram demonstrated multiple wall motion abnormalities, ejection fraction of 30 to 35% with almost global hypokinesis with akinetic areas in the mid septal, basal inferior, and inferoseptal areas, two-fourth diastolic dysfunction, mild mitral regurgitation, and mild pulmonary hypertension. Cardiac catheterization revealed severe triple vessel disease with left dominant system, and aneurysmal left main disease with a critical lesion of proximal circumflex with ulcerated plaque that was subsequently stented. The patient also had a 70% proximal left anterior descending (LAD) lesion and coronary artery to pulmonary artery fistulas originating from the left main coronary artery (►Fig. 1) and right coronary artery (►Fig. 2) with small shunt flow. DiscussionCoronary artery fistula (CAF) is an abnormal communication between a coronary and a heart chamber or any segment of the systemic or pulmonary circulation. These are often grouped together as coronary arterial-venous fistulas. A coronary artery connection to the pulmonary Keywords ► congestive heart failure ► fistulas ► cardiac catheterization ► angiography ► coronary arteries AbstractAn 86-year-old woman with history of hypertension, diabetes, hyperlipidemia, and coronary artery disease was admitted with new-onset congestive heart failure and pneumonia. She underwent coronary angiography after suffering a non-ST elevation myocardial infarction. There was severe coronary artery disease in addition to coronary artery-pulmonary fistulas involving proximal right coronary artery and a branch of left main coronary artery. Coronary artery fistula (CAF) is an abnormal communication between one or more coronary arteries and great vessels or a cardiac chamber. We reviewed 15 cases of CAFs published in PubMed and studied th...

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Section: Discussionmentioning

confidence: 99%

“…Percutaneous transcatheter closure is the safe and preferred method for anatomic approachable vessels. [2][3][4]8,[14][15][16]…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Coronary Artery Fistulas: Clinical Aspects and Brief Review of the Literature

2013

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Bilateral communicating coronary arteriovenous fistulas presenting with recurrent angina

Yang

Liu

Jeng

et al. 2012

Tzu Chi Medical Journal

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Communicating bilateral coronary artery to pulmonary artery fistula with aneurysms

Cited by 2 publications

References 17 publications

Diagnosis of Coronary Artery Fistulas: Clinical Aspects and Brief Review of the Literature

Diagnosis of Coronary Artery Fistulas: Clinical Aspects and Brief Review of the Literature

Bilateral communicating coronary arteriovenous fistulas presenting with recurrent angina

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