Echocardiographic Characterization of a Rare Type of Coronary Artery Fistula Draining into Superior Vena Cava

Ashmeik, Khalifa; Amin, Jatin; Pai, Ramdas G.

doi:10.1016/s0894-7317(00)70011-3

Cited by 8 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both ipsilateral (4 ×) and contralateral (1 ×) to the shunt, infarctions (2%) were reported only in patients with CVFs where the fistulas communicated to the right or left side of the vascular system; PA [9,27,[47][48][49] , SVC [10,50] , RVOT [12,51] and PV [52] . The mean age was 60.8 years (range, 51-78 years).…”

Section: MImentioning

confidence: 99%

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

View full text Add to dashboard Cite

AIM:To describe the characteristics of coronary artery fistulas (CAFs) in adults, including donor vessels and whether termination was cameral or vascular. METHODS:A PubMed search was performed for articles between 2000 and 2010 to describe the current characteristics of congenital CAFs in adults. A group of 304 adults was collected. Clinical data, presentations, diagnostic modalities, angiographic fistula findings and treatment strategies were gathered and analyzed. With regard to CAF origin, the subjects were tabulated into unilateral, bilateral or multilateral fistulas and compared. The group was stratified into two major subsets according to the mode of termination; coronary-cameral fistulas (CCFs) and coronary-vascular fistulas (CVFs). A comparison was made between the two subsets. Fistula-related major complications [aneurysm formation, infective endocarditis (IE), myocardial infarction (MI), rupture, pericardial effusion (PE) and tamponade] were described. Coronary artery-ventricular multiple micro-fistulas and acquired CAFs were excluded as well as anomalous origin of the coronary arteries from the pulmonary artery (PA). RESULTS:A total of 304 adult subjects (47% male) with congenital CAFs were included. The mean age was 51.4 years (range, 18-86 years), with 20% older than 65 years of age. Dyspnea (31%), chest pain (23%) and angina pectoris (21%) were the prevalent clinical presentations. Continuous cardiac murmur was heard in 82% of the subjects. Of the applied diagnostic modalities, chest X-ray showed an abnormal shadow in 4% of the subjects. The cornerstone in establishing the diagnosis was echocardiography (68%), and conventional contrast coronary angiography (97%). However, multislice detector computed tomography was performed in 16%. The unilateral fistula originated from the left in 69% and from the right coronary artery in 31% of the subjects. Most patients (80%) had unilateral fistulas, 18% presented with bilateral fistulas and 2% with multilateral fistulas. Termination into the PA was reported in unilateral (44%), bilateral (73%) and multilateral (75%) fistulas. Fistulas with multiple origins (bilateral and multilateral) terminated more frequently into the PA (29%) than into other sites (10.6%) (P = 0.000). Aneurysmal formation was found in 14% of all subjects. Spontaneous rupture, PE and tamponade were reported in 2% of all subjects. In CCFs, the mean age was 46.2 years whereas in CVFs mean age was 55.6 years (P = 0.003). IE (4%) was exclusively associated with CCFs, while MI (2%) was only found in subjects with CVFs. Surgical ligation was frequently chosen for unilateral (57%), bilateral (51%) and multilateral fistulas (66%), but percutaneous therapeutic embolization (PTE) was increasingly reported (23%, 17% and 17%, respectively). CONCLUSION:Congenital CAFs are currently detected in elderly patients. Bilateral fistulas are more frequently reported and PTE is more frequently applied as a therapeutic strategy in adults.

show abstract

Section: MImentioning

confidence: 99%

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

View full text Add to dashboard Cite

show abstract

“…Coronary angiography remains the gold standard for imaging the coronary tree. However, the relation of coronary fistulas to other cardiac structures is at times unclear, and their origin and course can be limited by overlap of adjacent structures (5)(6)(7)(8)(9)(10)(11)(12)(13). The aim of the present study was to evaluate the ability of multiplane color Doppler transesophageal echocardiography to identify these abnormalities.…”

mentioning

confidence: 99%

Assessment of congenital coronary artery fistulas by transesophageal color Doppler echocardiography

Vitarelli

Curtis

Conde

et al. 2002

The American Journal of Medicine

View full text Add to dashboard Cite

“…Four patients (7%) had no audible heart murmur at all and in 20 (35%) the murmur was not recorded. Systolic murmur alone was reported by several authors [59][60][61]. Cardiac murmurs are twice as frequent in women (68%) compared with men (35%).…”

Section: Discussionmentioning

confidence: 94%

Gender-related differences in octogenarians with congenital coronary artery fistula: a report of two cases and a review

2011

View full text Add to dashboard Cite

Aim To highlight gender-related differences in octogenarians with a congenital coronary artery fistula (CAF). Materials and methods We present two elderly female patients with a congenital fistula, a septuagenarian and a nonagenarian, and review the world literature between 1954-2010. Results The septuagenarian patient presented with easy fatigability and the nonagenarian patient with acute myocardial infarction contralaterally to the fistula. Coronary angiography (CAG) demonstrated a coronary-pulmonary artery fistula (CPF). The nonagenarian patient underwent percutaneous coronary intervention of the right coronary artery. CAG revealed a CPF associated with a huge multiple aneurysmal formation. Data from 57 mainly symptomatic patients with a mean age of 75.3 years (range 70-87 years) were collected. The cohort was subdivided into female (mean age 84.3 years) and male (mean age 75.2 years) subgroups and compared with each other. Multi-origin (bilateral and multilateral) was prevalent in females, 40% versus 12% in males. Aneurysmal formation was found in females and males in 40% and 18%, respectively. Ethnicity was 65% Caucasian and 35% Asian. Multi-origin fistulas were prevalent in the Asian (45%) compared with the Caucasian (11%) subset. Conclusions A septuagenarian and a nonagenarian female patient with congenital CAF are presented. On reviewing the literature, important differences were found between elderly females and males with congenital CAF.

show abstract

Echocardiographic Characterization of a Rare Type of Coronary Artery Fistula Draining into Superior Vena Cava

Cited by 8 publications

References 11 publications

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Assessment of congenital coronary artery fistulas by transesophageal color Doppler echocardiography

Gender-related differences in octogenarians with congenital coronary artery fistula: a report of two cases and a review

Contact Info

Product

Resources

About