Blood flow and pressure measurements of right coronary artery to left ventricle fistula.

Kiso, I; Itoh, Toyohiko; Morishita, Masataka; Kato, Kouki; Ishikura, Y

doi:10.1136/thx.33.2.253

Cited by 11 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cause of cardiomegaly in other cases may be due to left ventricular dilatation as a result of a large aortic run off via the fistulae. Cardiomegaly which has been associated with large amounts of blood diverted to the left ventricle has been previously described in the literature [14], The apparent cardiac enlargement seen in the chest X-ray of our case 4 is most likely due to a reduced antero-posterior chest diameter as a result of a very straight spine.…”

Section: Discussionmentioning

confidence: 71%

“…This appears also to be the case in coronary artery fistula draining into the right side of the heart [7], We postulate that the mechanism of myocardial isch aemia in our case 3 may be due to a siphoning of coronary blood flow to the left ventricle. Kiso et al [14] described a patient with right coronary-left ventricular fistula where intra-operative mean right coronary blood flow was recorded at 315 ml/min which might correspond to more than 20% of the cardiac output. After closure of the fistula, blood flow measurements showed only 35 ml/min suggesting that a large amount of blood was stolen by the fistula [14], Although their patient did not manifest myocardial isch aemia, these authors postulated that such a 'steal' phenomenon may cause reduced perfusion of the myocardium.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Coronary Artery-Left Ventricular Fistula

et al. 1981

View full text Add to dashboard Cite

Coronary artery-left ventricular fistulae are exceedingly rare and to date only 19 cases have been reported in the literature. We describe another four cases which we encountered recently. The first patient was a 10-year-old asymptomatic Indian male who was referred because of a to-and-fro murmur. Haemodynamic and angiographic studies revealed an aneurysmally enlarged right coronary artery draining into the left ventricle. The fistula was ligated and the patient has remained well over a 2½-year follow-up period. The second patient was a 13-year-old asymptomatic Chinese female referred also because of a to-and-fro murmur. Haemodynamic and angiographic studies showed a grossly enlarged right coronary artery draining into the left ventricle. This patient refused operation and has remained well over a 2-year follow-up period. The third patient was a 43-year-old Chinese male who presented with a 3-year history of angina pectoris and was admitted to hospital because of crescendo angina. The resting electrocardiogram showed marked ischaemic changes and the treadmill exercise stress test was also positive. Selective coronary angiography showed markedly dilated right and left coronary arteries. Multiple fistulae from the three major coronary arteries were seen to communicate with the left ventricle. It was elected to treat this patient medically with propranolol. He has remained well over a 6-month follow-up period. The fourth patient was a 5-year-old asymptomatic Chinese girl. Cardiac catheterization and selective coronary angiography revealed marked dilatation of the branches of the left coronary artery which communicated via a maize of fine vessels into the left ventricle. This patient has remained well over a 5-year follow-up period. The clinical presentation, investigations and treatment of coronary artery-left ventricular fistula are discussed and the literature regarding this subject is reviewed.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Coronary Artery-Left Ventricular Fistula

et al. 1981

View full text Add to dashboard Cite

show abstract

“…Accordingly, drainage into the left atrium or ventricle was present in only 8 [2]-24% [1] of these patients. The coronary artery proximal to the fistula can be normal or, in large shunts, can be tortuous, elongated, or aneurysmally dilated [1][2][3][4][5]. Postmortem findings include left ventricular hypertrophy, subendocardial fibrosis, dilated coronary arteries, and endothelial channels communicating with the cardiac chamber [6].…”

Section: Anatomymentioning

confidence: 99%

“…Arteriosystemic shunt calculations have been performed in very few patients. A shunt volume of 280 ml/min, or 20% of total cardiac output, was measured intraoperatively in a patient with an RCA to LV fistula [4]. In another patient with multiple fistulae to the left ventricle, a shunt flow of only 0.25% of total cardiac output could be documented at cardiac catheterization, using a technique that required cannulation of the left atrium [10].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Myocardial ischemia and infarction due to multiple coronary-cameral fistulae: Two case reports and review of the literature

Wolf

Rockson

1998

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

“…It may cause significant coronary blood flow steal. 1 A 62-year-old female with a history of angina underwent nuclear stress testing that demonstrated a reversible perfusion defect in the anterior wall of the left ventricle (Fig. 1A).…”

mentioning

confidence: 99%