Dual Fistulas of Ascending Aorta and Coronary Artery to Pulmonary Artery

Kim, Myoung-Joon; Kwon, Hee Jin; Hwang, Chi-Sung; Kang, Ji-Hyun; Kim, Hyeonjin; Kim, Seong-Man; Lee, Hyeon-Gook; Kim, Tae-Ik; Cho, Kyoung-Im

doi:10.4070/kcj.2011.41.4.213

Cited by 4 publications

(5 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The overwhelming majority of CPFs are congenital in origin, as was the case in our current series, but acquired fistulas subsequent to penetrating or nonpenetrating chest traumas have been reported. Furthermore, acquired CPFs have been reported as a late complication after stenting of the left main trunk with a paclitaxel‐eluting stent and secondary to CABG occurring between the left internal mammary artery graft and the PA, which give rise to the recurrence of angina and occurrence of a novel cardiac murmur .…”

Section: Discussionsupporting

confidence: 53%

“…Coronary‐pulmonary fistulas are generally congenital in origin, but acquired fistulas subsequent to penetrating or nonpenetrating chest traumas have been reported. Furthermore, although rare, they may be acquired late secondary to iatrogenic nonsurgical interventions such as PCI and following endomyocardial biopsy or after CABG .…”

Section: Discussionmentioning

confidence: 99%

“…The majority of CPFs are single (unilateral) communications, but bilateral (dual) fistulas and multilateral, triple, and quadruple fistulas have previously been described. Congenital fistulas in adult population are usually detected with noninvasive and invasive diagnostic imaging modalities. Functional assessment of CPFs may be achieved by myocardial perfusion imaging (MPI), cardiac magnetic resonance imaging, positron emission tomography‐computed tomography (PET‐CT), right heart catheterization, oximetric series, and recently by fractional flow reserve (FFR) of the nutrient artery .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature

Saïd

Nijhuis

Akker

et al. 2014

Clinical Cardiology

View full text Add to dashboard Cite

Background: Congenital coronary-pulmonary fistulas (CPFs) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral CPFs, the value of a multidetector computed tomography (MDCT) imaging technique as an adjuvant to coronary angiography (CAG) is eminent. The purpose of this study was to describe the clinical presentation, diagnostic modalities, and management of coincidentally detected congenital CPFs. Hypothesis: Unilateral and multilateral coronary-pulmonary fistulas are increasingly detected due to the wide speard application of multidetector computed tomography which might be a supplementary or replacing to conventional coronary angiography. Methods: We evaluated 14 adult patients with congenital coronary artery fistulas (CAFs) who were identified from several Dutch cardiology departments. Results: Fourteen adult patients (5 female and 9 male), with a mean age of 57.5 years (range, 24-80 years) had the following abnormal findings: audible systolic cardiac murmur (n = 4), chronic atrial fibrillation (n = 2), nonsustained ventricular tachycardia (n = 1), and cardiomegaly on chest x-ray (n = 2). Echocardiography revealed normal findings with trivial valvular abnormalities (n = 9), depressed left ventricle systolic function (n = 3), and severe mitral regurgitation and atrial dilatation (n = 2). The findings in the rest of the patients were unremarkable. CAG and MDCT were used as a diagnostic imaging techniques either alone (CAG, n = 6; MDCT, n = 1) or in combination (n = 7). Single modality and multimodality diagnostic methods revealed 22 fistulas including CPFs (n = 15), coronary cameral fistulas terminating into the right (n = 2) and the left atrium (n = 1), and systemic-pulmonary fistulas (n = 4). Of all of the fistulas, 10 were unilateral, 6 were bilateral, and 6 was hexalateral.13 N-ammonia positron emission tomography-computed tomography was performed in 3 patients revealing decreased myocardial perfusion reserve. Conclusions: CAG remains the gold standard for detection of CPFs. An adjuvant technique using MDCT provides full anatomical details of the fistulas.The authors have no funding, financial relationships, or conflicts of interest to disclose.

show abstract

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature

Saïd

Nijhuis

Akker

et al. 2014

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…Aortic lumen to pulmonary artery fistulas are rare and only 24 cases have so far been reported in the literature (Table ) . All patients were symptomatic and presented mainly with heart failure and/or chest pain.…”

Section: Aortopulmonary Fistulas Reported In the Literaturementioning

confidence: 99%

Two‐ and Three‐Dimensional Transthoracic Echocardiography in the Assessment of Aortic Arch Vasum Vasi to Pulmonary Artery Fistula

et al. 2013

View full text Add to dashboard Cite

We report an elderly patient presenting with a stroke and also hemolytic anemia secondary to mitral and tricuspid valve repair 3 years earlier, in whom two-dimensional transesophageal echocardiography (2DTEE) suspected a fistula into the pulmonary artery (APAF) from the posterior wall of the aortic arch. For further assessment, two-dimensional transthoracic echocardiography (2DTTE) and live/real time three-dimensional transthoracic echocardiography (3DTTE) were performed. 2DTTE showed findings similar to 2DTEE. Color Doppler guided continuous-wave Doppler showed continuous flow throughout the cardiac cycle with systolic preponderance across the fistula with a small peak pressure gradient of 22 mmHg. Sequential systematic cropping of the 3D datasets obtained from 3DTTE confirmed that the flow signals originated from the posterior wall of the aortic arch and not the lumen. Thus, 3DTTE served to increase the confidence level that the fistula most likely originated from a vasum vasi in the wall of the aortic arch. To our knowledge, this type of fistula has not been reported previously. Fistulas from the aortic lumen to the pulmonary artery are also rare and so far only 24 cases have been reported in the literature. These are also reviewed by us.

show abstract

“…Coronary fistula (CF) with a connection to the aorta is extremely rare and only known from single case reports. 1,2 In such fistulas, the closure of both arterial origins is essential for complete termination of the shunt. Here, complete closure of a CF communicating with the descending aorta was achieved through ligation of its coronary origin and endovascular covering of the aortic origin, which to the best of our knowledge, is the first report of such an approach.…”

Section: Introductionmentioning

confidence: 99%

Complete closure of coronary fistula communicating with the descending aorta

Kosiorowska

Lehmkuhl

Urbanski

2020

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

We report a rare case of complex coronary fistula that contained two aneurysms and was connected to the descending aorta. The fistula was also associated with further aortic pathologies necessitating surgery. Preoperative computed tomography angiography, which revealed an abnormal vessel communication, was crucial for choosing the appropriate operative strategy. During a one-stage procedure comprising closure of both arterial (aortic and coronary) fistula origins and repair of the aortic valve and thoracic aorta, the coronary origin of the fistula was ligated and the frozen elephant trunk technique was used to close the aortic origin.

show abstract

Dual Fistulas of Ascending Aorta and Coronary Artery to Pulmonary Artery

Cited by 4 publications

References 9 publications

Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature

Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature

Two‐ and Three‐Dimensional Transthoracic Echocardiography in the Assessment of Aortic Arch Vasum Vasi to Pulmonary Artery Fistula

Complete closure of coronary fistula communicating with the descending aorta

Contact Info

Product

Resources

About