Coronary Fistulas: A Case Series

Fennich, Nada; Fedoua, Elouali; Saghi, Ghita; Nadia, Bouzammour; Leila, Haddour; Zarzur, Jamila; Cherti, Mohamed

doi:10.5001/omj.2014.13

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…In many cases, simple but complex forms can be described. Unlike our case, the fistula drains primarily into the right cavity [7]. Drains into the left cavity.…”

Section: Discussioncontrasting

confidence: 50%

Coronaro Cameral Fistula: Literature Review, Diagnosis and Management, about a Case

Harouna,

Hamine,

Adam

et al. 2023

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A coronary fistula is defined as a direct connection between a coronary artery and a heart chamber, great vessel, or other vascular structure that "bypasses" the myocardial capillary bed. This is a rare pathology that is usually not discovered until later in life, and exceptionally not during childhood. We report the case of a young patient who was hospitalized for chest pain and shortness of breath and who was found to have a coronary fistula on angiography. A 66-year-old patient. Hypertension on dual therapy for 16 years and diabetes on OAD (Oral Antidiabetic) for 4 years. He was hospitalized with typical angina pectoris and dyspnea, and the stress test was positive. Laboratory examination revealed a good general condition with NYHA stage 3 dyspneic angina pectoris extending to the upper extremities and no evidence of heart failure. Looking at the balance, we see a slight increase in troponin. ECG returns to regular sinus rhythm, with electrical LVH (left ventricular hypertrophy) and ambient negative waves, no rhythm or conduction abnormalities. Transthoracic echocardiography (TTE) reverses hypertensive heart disease with good global and partial contractility without significant valvular disease associated with systolic pulmonary arterial pressure (SPAP) at 35 mmHg. Coronary angiography is performed and shows evidence of minor involvement of the central CX artery and a coronary camera fistula from the first diagonal artery draining into the left ventricle. Management was about optimizing medical care. The patient received an appointment and was declared discharged. Coronary camera fistulae are rare, found in approximately 0.3% of coronary angiographic studies performed. Most are congenital and may occur primarily due to trauma, erosive infection of the vessel wall, or iatrogenicity during transluminal coronary angioplasty, myocardial biopsy, or valve replacement. In many cases, simple but complex forms can be described. The gold standard for confirming the diagnosis remains coronary angiography, which highlights both the affected arteries and drainage sites. Cardiac scanners occupy an increasingly important position, especially as they provide morphologically accurate information. Surgical or percutaneous treatment of the fistula with a coil is recommended in symptomatic adult patients, especially those with significant or complicated right-to-left shunts. The authors suggest treatment with β-blockers when multiple sinusoidal fistulas associated with ventricular wall hypertrophy are present. Close monitoring is recommended for asymptomatic small fistula. Corneal fistula is a rare congenital or acquired condition that is mostly asymptomatic and discovered in adulthood. Coronary angiography and heart scan can be used to confirm the diagnosis. Treatment is usually surgical or endovascular. However, in some cases, drug treatment with beta-blockers may help.

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“…In many cases, simple but complex forms can be described. Unlike our case, the fistula drains primarily into the right cavity [7]. Drains into the left cavity.…”

Section: Discussioncontrasting

confidence: 50%

Coronaro Cameral Fistula: Literature Review, Diagnosis and Management, about a Case

Harouna,

Hamine,

Adam

et al. 2023

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Fístula coronaria de arteria circunfleja a vena cava superior

Domínguez-Massa

Bel-Mínguez

Pérez-Guillén

et al. 2018

Cirugía Cardiovascular

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Koronararterienanomalien: Diagnostik und Klassifikation auf Basis der CT und MRT des Herzens – von ALCAPA bis Terminationsanomalie

Heermann¹,

Heindel²,

Schülke³

2016

Fortschr Röntgenstr

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Coronary artery anomalies encompass a clinically and anatomically variable spectrum including physiological variants and pathophysiologically relevant anomalies. The majority of the variants has no hemodynamic relevance and is often detected accidentally. The recognition of the rare and relevant anomalies that cause either relevant shunt volumes leading to myocardial ischemia or ventricular tachyarrhythmias with the risk of sudden cardiac death is of major importance. This review is based on a literature search in PubMed conducted using the key words "coronary artery" and/or "anomaly" and/or "anomalous origin" and/or "myocardial bridging" and/or "coronary artery fistula" and/or "Bland-White-Garland" and/or "ALCAPA". Coronary artery anomalies can be anatomically subdivided into anomalies of origin, course and termination. The method of choice for anatomical imaging is ECG-triggered or gated multislice CT (MSCT) that provides high spatial resolution and the capability of multiplanar reconstructions. It facilitates the delineation of the precise course of all three coronary arteries and thus allows for correct classification in the anatomical classification system of coronary artery anomalies. The strengths of cardiac magnetic resonance imaging (CMR) are the evaluation of cardiac morphology, myocardial tissue properties and myocardial function. Basic methods are the analysis of myocardial contraction and perfusion with and without pharmacologic stress. Furthermore, potential shunt volumes could be quantified by phase contrast imaging or volumetry. · Coronary artery anomalies are subdivided into anomalies of origin, course and termination.. · The main imaging task is the differentiation of hemodynamically relevant anomalies from anatomic variants.. · The method of choice for anatomical imaging is MSCT, whereas structural and functional information is obtained by CMR. · Heermann P, Heindel W, Schülke C. Coronary Artery Anomalies: Diagnosis and Classification based on Cardiac CT and MRI (CMR) - from ALCAPA to Anomalies of Termination. Fortschr Röntgenstr 2017; 189: 29 - 38.

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Coronary Fistulas: A Case Series

Cited by 5 publications

References 17 publications

Coronaro Cameral Fistula: Literature Review, Diagnosis and Management, about a Case

Coronaro Cameral Fistula: Literature Review, Diagnosis and Management, about a Case

Fístula coronaria de arteria circunfleja a vena cava superior

Koronararterienanomalien: Diagnostik und Klassifikation auf Basis der CT und MRT des Herzens – von ALCAPA bis Terminationsanomalie

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