Multiple coronary to pulmonary artery fistulas: a case report and review of the literature

Taleb, Mohammad; Sheikh, Mujeeb; Cooper, Christopher J.; Tinkel, Jodi

doi:10.1007/s12928-012-0096-1

Cited by 16 publications

(19 citation statements)

References 26 publications

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“…5,6 Prognosis after successful closure is excellent, even in the absence of complete closure. 7 In this case, a complex CAF causing angina was treated by occluding the most important branch with transcatheter coil embolization, and even with incomplete closure, was able to improve symptoms and objective indices of myocardial ischemia.…”

Section: Discussionmentioning

confidence: 87%

Complex Coronary Artery Fistula Causing Angina is Resolved Through Coil Embolization

Lee

Kang

Koo

et al. 2015

J Lipid Atheroscler

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This is an Open Access article distributed under the terms of the creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Coronary artery fistulas (CAFs) are rare, mostly congenital cardiac anomalies. Most are asymptomatic and do not require treatment, but some can cause angina or exertional dyspnea. Symptomatic or hemodynamically significant fistulae can be treated with transcatheter or surgical methods of closure, with the former being a less invasive alternative while showing similar effectiveness and morbidity. We present a 52-year-old man with a complex coronary artery to pulmonary artery fistula causing angina, successfully treated by transcatheter coil embolization. Even without complete closure, this patient showed improvement of symptoms and objective indices of myocardial ischemia.

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Section: Discussionmentioning

confidence: 87%

Complex Coronary Artery Fistula Causing Angina is Resolved Through Coil Embolization

Lee

Kang

Koo

et al. 2015

J Lipid Atheroscler

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“…Successful transcatheter closure of a coronary artery fistula was first reported in 1983 (21). Since then, this treatment method has become more popular and is now widely avail- able (6,7,9,(18)(19)(20). Because of the low prevalence of coronary artery fistulas, the optimal management remains unclear and there are no established therapeutic guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the low prevalence of coronary artery fistulas, the optimal management remains unclear and there are no established therapeutic guidelines. Treatment with percutaneous intervention or surgery is recommended for patients with symptoms such as chest pain and dyspnea (4,10,15,(18)(19)(20) and to prevent the development of heart failure (4-7), myocardial ischemia (4, 6, 8-10), endocarditis (11) or rupture of aneurysmal vessels (12)(13)(14). Cebi et al indicated that symptomatic coronary artery fistulas should be closed irrespective of the size of the left-to-right shunt (4).…”

Section: Discussionmentioning

confidence: 99%

“…In this case, we successfully performed percutaneous coil embolization even though the fistula was large and tortuous. Recent improvements in endovascular techniques and devices have resulted in the increased use of percutaneous intervention for the noninvasive treatment of coronary artery fistulas (6,7,9,(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

“…The majority of coronary artery fistulas originate from the right coronary artery or left anterior descending artery (LAD) and connect with a pulmonary artery, pulmonary vein, cardiac chamber, coronary sinus or the vena cava (15)(16)(17). Symptomatic coronary artery fistulas should be treated with percutaneous intervention or surgery (4,10,15,(18)(19)(20). We herein report a case of successful percutaneous coil embolization of a large and anatomically complex coronary artery to pulmonary artery fistula.…”

Section: Introductionmentioning

confidence: 99%

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Successful Percutaneous Coil Embolization of a Large and Tortuous Coronary Artery to Pulmonary Artery Fistula

et al. 2013

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We herein report the case of a 73-year-old woman with a large and tortuous coronary artery to pulmonary artery fistula treated with percutaneous coil embolization. The patient was hospitalized due to unstable angina with an elevated serum troponin-T level. Coronary angiography revealed no significant atherosclerotic stenosis, with a large and tortuous coronary artery to pulmonary artery fistula originating from the proximal portion of the left anterior descending artery. We successfully performed percutaneous coil embolization of the fistula. In this case, 320-slice multidetector computed tomography played a pivotal role in the diagnosis and percutaneous intervention.

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Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature

Saïd

Nijhuis

Akker

et al. 2014

Clinical Cardiology

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Background: Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral CPFs, the value of a multidetector computed tomography (MDCT) imaging technique as an adjuvant to coronary angiography (CAG) is eminent. The purpose of this study was to describe the clinical presentation, diagnostic modalities, and management of coincidentally detected congenital CPFs. Hypothesis: Unilateral and multilateral coronary-pulmonary fistulas are increasingly detected due to the wide speard application of multidetector computed tomography which might be a supplementary or replacing to conventional coronary angiography. Methods: We evaluated 14 adult patients with congenital coronary artery fistulas (CAFs) who were identified from several Dutch cardiology departments. Results: Fourteen adult patients (5 female and 9 male), with a mean age of 57.5 years (range, 24-80 years) had the following abnormal findings: audible systolic cardiac murmur (n = 4), chronic atrial fibrillation (n = 2), nonsustained ventricular tachycardia (n = 1), and cardiomegaly on chest x-ray (n = 2). Echocardiography revealed normal findings with trivial valvular abnormalities (n = 9), depressed left ventricle systolic function (n = 3), and severe mitral regurgitation and atrial dilatation (n = 2). The findings in the rest of the patients were unremarkable. CAG and MDCT were used as a diagnostic imaging techniques either alone (CAG, n = 6; MDCT, n = 1) or in combination (n = 7). Single modality and multimodality diagnostic methods revealed 22 fistulas including CPFs (n = 15), coronary cameral fistulas terminating into the right (n = 2) and the left atrium (n = 1), and systemic-pulmonary fistulas (n = 4). Of all of the fistulas, 10 were unilateral, 6 were bilateral, and 6 was hexalateral.13 N-ammonia positron emission tomography-computed tomography was performed in 3 patients revealing decreased myocardial perfusion reserve. Conclusions: CAG remains the gold standard for detection of CPFs. An adjuvant technique using MDCT provides full anatomical details of the fistulas.The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Multiple coronary to pulmonary artery fistulas: a case report and review of the literature

Cited by 16 publications

References 26 publications

Complex Coronary Artery Fistula Causing Angina is Resolved Through Coil Embolization

Complex Coronary Artery Fistula Causing Angina is Resolved Through Coil Embolization

Successful Percutaneous Coil Embolization of a Large and Tortuous Coronary Artery to Pulmonary Artery Fistula

Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature

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