Coronary-Pulmonary Artery Fistula Associated with Right Heart Failure: Successful Closure of Fistula with a Graft Stent

Abstract

Coronary artery fistula constitutes a rare congenital anomaly. The reported incidence of this anomaly ranges from 0.1% to 0.2% of the population undergoing coronary angiography. Coronary-pulmonary artery fistula is an extremely rare congenital anomaly of the coronary artery. Its real incidence is unknown. The authors report a case of coronary-pulmonary artery fistula that caused right heart failure in a 77-year-old woman. The fistula, arising from a proximal portion of the circumflex artery to the pulmonary artery, was sealed successfully using a Jostent (polytetrafluoroethylene-covered graft stent).

Congenital coronary artery fistulas complicated with pulmonary hypertension: Analysis of 211 cases

“…Between 1986 and 2014, papers published describing Asian population with congenital CAFS and reported data on PAP were included: from 1986-1993[23-28], 1994-1999[29-33], 2001-2004[34-39], 2005[40-42], 2006[43-49], 2007[50-55], 2009-2011[56-61] and 2012-2014[62-69]. PAP was measured by RHC in 107 and by Doppler echocardiography in 4.…”

Congenital Heart Diseases in Aged Patients

“…CAAs are frequently managed in the elderly with angioplasty and stenting in the case of single coronary anomaly, 35 origin from the opposite sinus, 36 coronary fistulas, 37 and myocardial bridges. 38 Endovascular management of coarctation of the aorta with angioplasty and stenting has not been reported in the elderly; as a result of the fragility of the aorta and the association with aneurysmal ductus, stent-graft repair has been proposed as the primary therapeutic tool.…”

Coronary to pulmonary fistula as the primary source of pulmonary blood supply in pulmonary atresia with ventricular septal defect

“…For patient in whom the coronary artery-pulmonary artery is too small to provide adequate pulmonary blood flow, and who require surgical aid before the age of 4 or 5 years, we prefer a systemic-to-pulmonary anastomosis (such as blalock anastomosis) and defer the definitive operation until the age of 5 years, or a little older. 12 The morbidity and mortality rates and late result for correcting this deformity and the long term result currently should be similar to those for the repair of severe tetralogy.…”