Left circumflex coronary artery to left atrial fistula in a patient with mitral regurgitation after excision of a left atrial myxoma

Coronary artery fistulas are rare congenital anomalies of coronary termination. There are 3 types: (1) cameral coronary fistulas, (2) pulmonary coronary fistulas, and (3) bronchial coronary fistulas. Left circumflex coronary artery to left atrial fistula are exceptional. Imaging, especially the CT angiogram, must establish an anatomical classification of the fistula for therapeutic purposes, by specifying its origin, its path, its size and its termination. We report a rare case of the left circumflex coronary artery to left atrial fistula in a 31 year old man, which is an uncommon presentation of coronary termination anomalies. The CT coronary angiogram must describe the origin segment of the fistula and the drainage site which have therapeutic consequences.

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“…Left circumflex coronary artery to left atrial fistula, as in our patient, has been rarely reported in the littérature [2 , 12] .…”

Section: Discussionmentioning

confidence: 65%

“…It means abnormal connection between the coronary artery and a cardiac cavity or blood vessel without going through the capillary circulation. There are 3 types: (1) cameral coronary fistulas (coronary cavitary fistula), (2) pulmonary coronary fistulas, and (3) bronchial coronary fistulas [1 , 2] .…”

Section: Discussionmentioning

confidence: 99%

Left circumflex artery fistula to left atrium: a rare case report

Imrani

Amalik

Billah

et al. 2021

Radiology Case Reports

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“…It is in general well circumscribed and has an ovular form. Moreover, angiographic demonstration of abnormal vessels arising from the coronary arteries has been for long time reported as being an isolated congenital cardiac anomaly, concomitant with cardiac tumors, especially myxomas [2]. …”

Section: Discussionmentioning

confidence: 99%

A Neovascularized Left Atrial Mass

Hammami

Abid

Mallek

et al. 2012

Case Reports in Medicine

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Background. The discovery of a large left atrial mass through echocardiography obliges the clinician to perform a differential diagnosis to distinguish tumor from thrombus. The neovascularization of the mass could be helpful to predict the type of the malformation and whether it is in favour of a vacular tumour rather than a thrombus . Observation. A 43-years-old man who had no cardiac antecedent reported that he have had dyspnea and palpitation since 10 months. The cardiac auscultation, revealed an irregular rhythm with diastolic murmur at the apex. The electrocardiogram showed an atrial fibrillation. The transthoracic echocardiography revealed a severe mitral stenosis with a huge left atrial mass, confirmed through transesophageal echocardiography. After 4 weeks of an efficient anticoagulant treatment, the mass was still persistent in the echocardiography. So we decided to resect the mass and to achieve a mitral valve replacement. The preoperative coronarography showed neovascularization among the mass and fistula from the circumflex artery. Considering the characteristic of the mass (neovascularization and resistance to anticoagulant), we strongly suspected a vascular tumor especially myxoma, but the histological exam revealed an organized thrombus. Conclusion. Coronary neovascularization is a specific sign for left atrial thrombus in mitral stenosis, but surgery is the best way to confirm diagnosis.

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“…In patients with cardiac myxoma, coronary evaluation is not routinely performed, but 37%–52% of cases with cardiac myxoma exhibit feeding vessels from the coronary artery 1,2 . The feeding vessels from the coronary artery should be ligated to prevent the development of a coronary artery‐to‐left atrial fistula during the follow‐up period 3,4 …”

Section: Figurementioning

confidence: 99%

“…1,2 The feeding vessels from the coronary artery should be ligated to prevent the development of a coronary artery-to-left atrial fistula during the follow-up period. 3,4 As a result, every patient with cardiac mass does not need coronary artery evaluation. However, cardiac mass combined with cystic lesion could be a subtype of myxoma having a feeding vessel, and this type of cardiac mass must undergo a coronary evaluation to rule out a feeding vessel.…”

Section: Myxomamentioning

confidence: 99%

Left atrial myxoma presenting as a mass with cystic component

Lee,

Kim,

Song

2024

Echocardiography

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Left circumflex coronary artery to left atrial fistula in a patient with mitral regurgitation after excision of a left atrial myxoma

Cited by 11 publications

References 6 publications

Left circumflex artery fistula to left atrium: a rare case report

Left circumflex artery fistula to left atrium: a rare case report

A Neovascularized Left Atrial Mass

Left atrial myxoma presenting as a mass with cystic component

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