Diffuse Bilateral Coronary Artery Fistulae Entering the Left Ventricle: A Case Confirmed Surgically A Case Report

Abstract

A 65-year-old woman presented with intermittent left bundle branch block and angina pectoris. Cardiac catheterization demonstrated bilateral coronary artery fistulae entering diffusely into the left ventricle without evidence of major arterial-luminar shunt. A surgical procedure to reduce the arterial-to-cameral flow is discussed, and case reports are reviewed and discussed.

Dutch survey of congenital coronary artery fistulas in adults: Coronary artery-left ventricular multiple micro-fistulas

“…In agreement with previous reports, patients with CALVMMFs are more often female than male patients [6][7][8][9][10]14,15,17,19]. In the current study, females composed 65% of the cohort.…”

“…Although surgical strategy for CALVMMFs has sporadically been reported in the literature [19], it is generally agreed that conservative medical management is the primary treatment of choice [8,20,21].…”

A case of coronary cameral fistula

“…An arterio-capillary variant has also been described. 3 The vast majority (90%) of cameral fistulae communicate with the right-sided chambers of the heart and in the remainder of cases will drain to the left side of the heart or to both. 4 Fistulae usually arise predominantly from one of the two major coronary arteries, however, in a small proportion of cases (5%) communications may arise from both coronary arteries.…”

A Coronary Cameral Fistula Draining Into Left Ventricle: A Rare Finding

“…Large communication can lead to heart failure in the later stages of life due to the constant volume overload to the ventricle. Rupture of the aneurysm and infective endocarditis are also reported in a few cases [4].…”

“…In the second form, the arterio-sinusoidal type, the communication is through the myocardial sinusoidal network. In the arterio-capillary fistula, the arterial vessels drain into the capillaries and then through the small cardiac veins, known as Thebesian veins, into the heart chamber [4].…”