Coronary-cameral fistula in association with intracardiac tumour and aortic stenosis in an adult

Acquired coronary artery–pulmonary artery connection

“…Coronary artery fistulas are uncommon and, typically, congenital, although rare reports of acquired arterio- venous malformations have implicated tumor, thrombus, injury, or ischemia [1][2][3][4][5][6][7][8]. While our patient had previously had a mediastinal tumor, no abnormal vascularity was noted at the time of resection, and the patient had survived 15 years without evidence of recurrent malignant disease, thus making tumor neovascularization unlikely.…”

“…More than 90% of these drain into the right side of the heart, with approximately 15% draining into the pulmonary circulation [1]. Acquired coronary artery malformations are uncommon, and have been reported in association with myocardial ischemia [2], mural thrombi [3][4], penetrating trauma [5][6], and intracardiac tumors [7][8]. In these cases, acquired fistulas have developed from coronary artery to coronary artery, or as arteriocameral fistulas.…”

Coronary angiographic morphology of congenital coronary arteriovenous fistulas in adults: Report of four new cases and review of angiograms of fifteen reported cases

“…When adult patients are evaluated, the possibility of acquired as well as congenital coronary arteriovenous fistulas has to be taken into account. Clinically, the two conditions can "Clinical and follow-up data of cases 5-19 have been the subject of earlier reports [ 2,7,19,20,23,35,36,38]. bRCA = right coronary artery; LAD = left anterior descending coronary artery; CX = circumflex coronary artery.…”

“…In the selected series of Giannroccoano et al [34], transesophaged echocardiography confirmed the presence of coronary artery anomalies detected by angiography and helped to locate the course and drainage site of CAVFs. CAVFs associated with intracardiac tumor are rare [35] and multiple fistulas are even rarer [36]. Although these abnormalities have been associated with longevity [37,38], the spontaneous resolution of CAVF is rare.…”

“…The clinical findings and long-term, follow-up data of the fifteen reported patients have been published elsewhere [2,7,19,20,23,35,36,38]. Coronary angiographic findings of all 19 patients (23 CAVFs) are presented in Table I.…”