Monster left circumflex artery fistula closure by vascular plug in a patient with post‐COVID‐19 myocardial infarction

Abstract

Herein, we report a man with a huge coronary fistula connecting the left circumflex coronary artery to the right ventricle. During the follow‐up, the patient developed progressive symptoms of heart failure nonresponsive to medical treatment. Therefore, an endovascular closure with a vascular plug was successfully done for him. Transcatheter vascular plug occlusion can be considered as an alternative for closure of symptomatic high‐flow large coronary artery fistulas in patients with a high risk of surgery and chance of coil dislocation, embolization, or unavailability of proper coils.

Case report: Right coronary artery to left ventricular fistula complicated with coronary artery dilation presenting as persistent cardiogenic ischemic chest pain

“…The common symptoms of CAF include dyspnea, palpitations, and chest pain ( 6 , 8 ). This patient complained of persistent chest pain during his first visit to the doctor.…”

“…Right coronary artery fistula (RCAF) is more common than left coronary artery fistula ( 2 ), and the receiving chamber usually includes the right ventricle (45%), the right atrium (25%) and the pulmonary artery (20%) ( 3 ), while it is rare to include the left atrium or left ventricle (LV) ( 4 , 5 ). The etiology of CAF includes congenital, traumatic or iatrogenic ( 4 , 6 ). Large CAFs can lead to congestive heart failure, myocardial infarction, pulmonary hypertension, etc ( 2 , 5 , 7 ).…”

“…Large CAFs can lead to congestive heart failure, myocardial infarction, pulmonary hypertension, etc ( 2 , 5 , 7 ). Patients usually complain of dyspnea, palpitation and chest pain ( 6 , 8 ). Closure of fistula is usually considered as the top priority treatment option ( 2 ).…”