Giant coronary artery fistula complicated by cardiac tamponade

Gamma, Reto; Seiler, Jens; Moschovitis, Giorgio; Mohaçsi, Paul; Berdat, Pascal A.; Zenklusen, Regula Zürcher; Tüller, David; Walpoth, Nazan

doi:10.1016/j.ijcard.2005.01.065

Cited by 9 publications

(11 citation statements)

References 5 publications

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“…The appearance of CAF is most frequently arterioluminal but occasionally aneurysmal. CAF may result in serious complication such as congestive heart failure, myocardial ischemia, pulmonary hypertension, infectious endocarditis, and rupture of aneurysmal-CAF [3,5]. It is well accepted that all symptomatic patients as in this case should be treated with surgical repair because the surgical risk in most cases appears to be considerably less than the potential development of serious and fatal complications [4,5].…”

Section: Discussionmentioning

confidence: 92%

Left main coronary trunk connecting into right atrium with an aneurysmal coronary artery fistula

Shiga

Tsuchiya

Yahiro

et al. 2008

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 92%

Left main coronary trunk connecting into right atrium with an aneurysmal coronary artery fistula

Shiga

Tsuchiya

Yahiro

et al. 2008

International Journal of Cardiology

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“…An origin from the LMT was reported infrequently in 17 patients in total (7%). The fistulas terminated mostly into the right heart side [10][11][12][13][14][15]85] . Outflow was mostly into the main PA (47%) [2,61,86] , with distribution to the left [80] or right PA branch [87] .…”

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

“…By means of echocardiography, right-sided pressure could be estimated and the left-to-right shunt (ratio of pulmonary to systemic blood flow) could be calculated [24,47,51,81,82] . Rupture of an aneurysm associated with CAFs causing PE and tamponade was easily illustrated by echocardiography [15,83,84] . Angiographic fistula characteristics related to the origin and number of donor vessels: Unilateral fistulas were found in 80% of subjects (Table 1).…”

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

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Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

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AIM:To describe the characteristics of coronary artery fistulas (CAFs) in adults, including donor vessels and whether termination was cameral or vascular. METHODS:A PubMed search was performed for articles between 2000 and 2010 to describe the current characteristics of congenital CAFs in adults. A group of 304 adults was collected. Clinical data, presentations, diagnostic modalities, angiographic fistula findings and treatment strategies were gathered and analyzed. With regard to CAF origin, the subjects were tabulated into unilateral, bilateral or multilateral fistulas and compared. The group was stratified into two major subsets according to the mode of termination; coronary-cameral fistulas (CCFs) and coronary-vascular fistulas (CVFs). A comparison was made between the two subsets. Fistula-related major complications [aneurysm formation, infective endocarditis (IE), myocardial infarction (MI), rupture, pericardial effusion (PE) and tamponade] were described. Coronary artery-ventricular multiple micro-fistulas and acquired CAFs were excluded as well as anomalous origin of the coronary arteries from the pulmonary artery (PA). RESULTS:A total of 304 adult subjects (47% male) with congenital CAFs were included. The mean age was 51.4 years (range, 18-86 years), with 20% older than 65 years of age. Dyspnea (31%), chest pain (23%) and angina pectoris (21%) were the prevalent clinical presentations. Continuous cardiac murmur was heard in 82% of the subjects. Of the applied diagnostic modalities, chest X-ray showed an abnormal shadow in 4% of the subjects. The cornerstone in establishing the diagnosis was echocardiography (68%), and conventional contrast coronary angiography (97%). However, multislice detector computed tomography was performed in 16%. The unilateral fistula originated from the left in 69% and from the right coronary artery in 31% of the subjects. Most patients (80%) had unilateral fistulas, 18% presented with bilateral fistulas and 2% with multilateral fistulas. Termination into the PA was reported in unilateral (44%), bilateral (73%) and multilateral (75%) fistulas. Fistulas with multiple origins (bilateral and multilateral) terminated more frequently into the PA (29%) than into other sites (10.6%) (P = 0.000). Aneurysmal formation was found in 14% of all subjects. Spontaneous rupture, PE and tamponade were reported in 2% of all subjects. In CCFs, the mean age was 46.2 years whereas in CVFs mean age was 55.6 years (P = 0.003). IE (4%) was exclusively associated with CCFs, while MI (2%) was only found in subjects with CVFs. Surgical ligation was frequently chosen for unilateral (57%), bilateral (51%) and multilateral fistulas (66%), but percutaneous therapeutic embolization (PTE) was increasingly reported (23%, 17% and 17%, respectively). CONCLUSION:Congenital CAFs are currently detected in elderly patients. Bilateral fistulas are more frequently reported and PTE is more frequently applied as a therapeutic strategy in adults.

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“…This search resulted in 14 published reports. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] The following criteria were stipulated in order to obtain a homogenous cohort of study: patients >18 years of age, clinical presentation, confirmation of diagnosis, findings of pathologic anatomy, and treatment modality.…”

Section: Literature Searchmentioning

confidence: 99%

Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

Saïd

Schroeder‐Tanka

Mulder³

2008

Congenital Heart Disease

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Rupture of congenital aneurysmal fistulas occurred more often in females. Identified risk factors for rupture, hemopericardium, tamponade, and death were among others saccular aneurysm, Asian ethnic race, origin of the aneurysmal fistulas from the left coronary artery and a history of hypertension may play a role. In this article, we present a literature review of congenital aneurysmal fistulas associated with or without rupture and a case report of a woman with unruptured aneurysmal fistula.

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Giant coronary artery fistula complicated by cardiac tamponade

Cited by 9 publications

References 5 publications

Left main coronary trunk connecting into right atrium with an aneurysmal coronary artery fistula

Left main coronary trunk connecting into right atrium with an aneurysmal coronary artery fistula

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

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