Coronary artery fistulae

Ali, Mahboob; Kassem, Kamal M; Osei, Kofi; Effat, Mohamed

doi:10.1007/s11239-019-01897-8

Cited by 16 publications

(24 citation statements)

References 17 publications

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“…Once cardiac imaging confirmed the congenital anomaly, however, surgical management was suggested. A recent article by Ali et al outlines an algorithm for the management of coronary fistula either by transcatheter intervention or a more invasive surgical route based on symptoms, size, location and characterization of the fistula [9].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Bacteremia in the Setting of a Coronary Artery Fistula

Shah

Jobanputra

Sharma

2020

Cureus

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We present an interesting case of a 31-year-old female with recurrent Staphylococcus lugdunensis bacteremia in the setting of a coronary artery fistula (CAF). Over the course of several months, the patient was admitted to the hospital on three separate occasions with an unclear source of bacteremia. She suffered from numerous complications, including cavitary pneumonia, osteomyelitis, synovitis and septic emboli. On each admission, the patient received intravenous (IV) antibiotic therapy. CT scan of the chest with contrast on the third admission revealed a prominent tortuous vessel coursing from the ascending aorta and main pulmonary artery to the left atrium. Coronary CT angiogram confirmed the presence of a fistula connecting the left circumflex artery to the coronary sinus. Common complications of CAF include infective endocarditis and myocardial ischemia; however, we report a novel case of recurrent bacteremia in the context of an anomalous coronary artery. Two months after diagnosis, surgical closure of the CAF was performed. This case illustrates the importance of utilizing different cardiac imaging modalities in order to diagnose congenital cardiac anomalies in a timely fashion and intervene appropriately.

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Section: Discussionmentioning

confidence: 99%

Recurrent Bacteremia in the Setting of a Coronary Artery Fistula

Shah

Jobanputra

Sharma

2020

Cureus

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“…CAF involves communication of the main coronary artery or branch of the right or left coronary artery and the cardiac chambers or the large vessels . Congenital CAF involves abnormal communication between the coronary artery and cardiac cavity that results from abnormal embryonic development of the sinusoidal space in the myocardium.…”

Section: Discussionmentioning

confidence: 99%

Right coronary artery‐coronary sinus fistula diagnosed by three‐dimensional echocardiography

Wang

2020

J of Clinical Ultrasound

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Right coronary artery‐coronary sinus fistula is a very rare congenital anomaly in which a right coronary artery fistula drains into the right atrium, right ventricle, or pulmonary artery. A right coronary artery‐coronary sinus fistula was diagnosed in a 44‐year‐old man by three‐dimensional echocardiography and confirmed by computed tomography angiography and surgery. Relevant published experience in diagnosing this kind of anomaly is summarized.

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“…ACFs could result from MI, hypertrophic cardiomyopathy, dilated cardiomyopathy, tumor, PCI, CABG, cardiac transplant, cardiac biopsy, and pacemaker placement, among other etiologies [14][15][16]. Rupture of the microvasculature may be the most important cause of ACFs [17,18].…”

Section: Discussionmentioning

confidence: 99%

Dose All of the Coronary Fistulas been Created by the Reopening Wire After Successful Revascularization of Chronic Total Occlusion?

Fan¹,

Tan²,

Song³

et al. 2020

Preprint

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Background: Coronary fistulas may be congenital or acquired generally as consequence of coronary interventions, mainly chronic total occlusion (CTO) reopening. When the reopening wire passes through the occlusion it may microperforate the advential vascular layers, favoring the fistulous communication between coronary vessel and cardiac chambers. But some of acquired coronary fistulas (ACFs) had been already present at the CTO vessels and would been seen after revascularization. This study was designed to investigate the characteristics of ACFs, which albeit mostly benign can cause concern and unnecessary treatment post successful CTO percutaneous coronary intervention (PCI).Methods: Data, including clinical and procedural characteristics, medical history, and findings in electrocardiography, echocardiography and coronary angiography, from 2169 consecutive patients undergoing CTO PCI between January 2018 and December 2019 were analyzed retrospectively. Results: 1844 (85.0%) underwent successful CTO PCI with complete revascularization. Among them, there were 49 cases (mean age, 62.80 ± 11.24 years; 40 men) of ACFs: 24 (49%) involved the right coronary artery, 19 (38.8%) the left anterior descending artery, and 6 (12.2%) the circumflex branch; and 38 (77.6%) were coupled with multiple fistulas (>3), and 29 (59.2%) affected multiple branches of the CTO vessel (>3). The majority of patients with ACFs had a history of MI or Q-wave (n=34, 69.4%), and angina was the most common complaint (n=41, 83.7%). None of them had pericardial effusion, tamponade and Hemodynamic abnormalities before or after PCI.Conclusion: ACFs after successful CTO PCI mostly developed in patients with MI history, originated from the right coronary artery or left anterior descending artery, and involved multiple fistulas and CTO vessel branches.

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Coronary artery fistulae

Cited by 16 publications

References 17 publications

Recurrent Bacteremia in the Setting of a Coronary Artery Fistula

Recurrent Bacteremia in the Setting of a Coronary Artery Fistula

Right coronary artery‐coronary sinus fistula diagnosed by three‐dimensional echocardiography

Dose All of the Coronary Fistulas been Created by the Reopening Wire After Successful Revascularization of Chronic Total Occlusion?

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