Cardiac tamponade due to ruptured coronary-pulmonary artery fistula aneurysm: a case report

Abstract

Background Coronary artery fistulas are rare and most commonly asymptomatic; however, they can become enlarged and rupture in some cases. Case summary We report a case of a 51-year-old woman who was brought to our hospital unconscious in an ambulance. Cardiac tamponade caused by the rupture of an aneurismal coronary-pulmonary artery fistula (CPAF) was detected by contrast-enhanced computed tomography and confirmed by invasive coronary angiography. Due to prompt diagnosis and subsequent surgical intervention, the patient’s condition was rapidly improved, and she was discharged from the hospital. Discussion Coronary-pulmonary artery fistula aneurysm rupture requires rapid diagnosis and treatment, and thus, in cases with cardiac tamponade and coronary aneurysm, CPAF aneurysm rupture should be considered.

Coil Embolization of a Left Anterior Descending Coronary Artery-Pulmonary Artery Fistula: A Case Report

“…However, TCC cannot be performed in cases of a tortuous vessel or a large fistula[ 5 ]. The indications for surgical management of fistulas are severe pulmonary hypertension, prior history of bacterial endocarditis, asymptomatic fistulas with a left-to-right shunt of 30%, and fistulas with an enlarged aneurysm, particularly those with a diameter exceeding 3 cm, which poses a higher risk of rupture[ 6 ]. Other modalities for managing coronary artery fistulas include the use of covered stents, detachable balloons, and atrial septal defect devices [ 7 ].…”

Cinematic rendering of the coronary-pulmonary arterial fistula

“…With increasing patient age, the fistula gradually enlarges with increased shunt flow via the fistula in children [7] . Coronary artery fistulas should be treated if the fistula is large with substantial shunt flow that may lead to myocardial ischemia, ventricular dysfunction, and congestive heart failure, surgical ligation and catheterization are common treatments for coronary artery fistulas [8] . Prompt diagnosis and obtain accurate morphological evaluation of blood vessels are essential for precise surgical treatment [9] .…”

Successful Surgical Treatment for Ruptured Aneurysm of Coronary-Pulmonary Artery Fistula Complicated With Cardiac Tamponade

“…Fortunately, hemodynamics were dramatically improved after pericardial drainage in the present case, which allowed us to schedule the MDCT and an elective operation. On the other hand, Hijikata et al 6 reported a case of ruptured CPAF aneurysm that required emergency surgery. Nevertheless, even in that acute clinical setting, they were able to immediately evaluate the morphology of the CPAF with MDCT and subsequently performed its complete resection.…”