Prophylactic and therapeutic embolization of coronary-bronchial artery fistula in patient with Bronchiectasis

Shin, Kwen Chul; Shin, Mi-Seung; Park, Jeong Woong; Kang, Woong Chol; Kim, Eui Joo; Lee, Kyoung Hoon; Moon, Chan Il; Shin, Eak Kyun

doi:10.1016/j.ijcard.2010.05.036

Cited by 7 publications

(10 citation statements)

References 9 publications

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“…In our patient, a decrease in myocardial contraction was observed in the RCA territory. Shin et al [6] have demonstrated that functional tests including the myocardial perfusion scanning are helpful in the diagnosis of coronary-bronchial artery fistula. A great variety of clinical features have been reported in patients who has coronary-bronchial artery fistula.…”

Section: Discussionmentioning

confidence: 99%

“…Closure of coronary-bronchial artery fistula is mainly indicated for patients with heart failure, myocardial ischemia, or high-flow shunting. Shin et al [6] have proposed prophylactic and therapeutic embolization of coronary-bronchial artery fistula in patients with bronchiectasis. Embolization, which is less invasive, has recently been attempted.…”

Section: Discussionmentioning

confidence: 99%

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Coronary-Bronchial Artery Fistula Manifested by Hemoptysis and Myocardial Ischemia in a Patient with Bronchiectasis

Lee

Chee

et al. 2012

Korean J Thorac Cardiovasc Surg

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A coronary-bronchial artery fistula is a very rare congenital anomaly of the coronary artery whose etiology and pathogenesis have not yet been clarified. Most patients with coronary-bronchial fistulas are asymptomatic; however, some patients present with congestive heart failure, infective endocarditis, myocardial ischemia induced by a coronary steal phenomenon, or rupture of an aneurysmal fistula. Furthermore, patients with a coronary-bronchial artery fistula rarely manifest life-threatening hemoptysis due to the associated bronchiectasis. We report herein the case of a patient with a coronary-bronchial artery fistula who had bronchiectasis and a history of massive hemoptysis and myocardial ischemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coronary-Bronchial Artery Fistula Manifested by Hemoptysis and Myocardial Ischemia in a Patient with Bronchiectasis

Lee

Chee

et al. 2012

Korean J Thorac Cardiovasc Surg

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“…The aetiology of CBFs is uncertain. CBFs are often associated with bronchiectasis which may be bilateral [1] or unilateral either to the left [2] or to the right lung [3]. Sometimes CBFs occur concomitant with tetralogy of Fallot, supravalvular aortic stenosis or Takayasu aortitis [4].…”

Section: Introductionmentioning

confidence: 99%

“…The morphology may be shown using several diagnostic modalities: CAG, magnetic resonance imaging (MRI) and multi-detector computed tomography (MDCT). MDCT identified the course of CBFs between the circumflex artery (Cx) and the bronchial arteries [2, 5] and myocardial perfusion imaging (MPI) revealed reversible defects [5]. The functional assessment may be obtained by MPI using technetium-99 m tetrofosmin, MRI and oximetric series during cardiac catheterisation to establish the magnitude of the shunt.…”

Section: Introductionmentioning

confidence: 99%

Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature

et al. 2014

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BackgroundCoronary bronchial artery fistulas (CBFs) are rare anomalies, which may be isolated or associated with other disorders.Materials and methodsTwo adult patients with CBFs are described and a PubMed search was performed using the keywords “coronary bronchial artery fistulas” in the period from 2008 to 2013.ResultsTwenty-seven reviewed subjects resulting in a total of 31 fistulas were collected. Asymptomatic presentation was reported in 5 subjects (19 %), chest pain (n = 17) was frequently present followed by haemoptysis (n = 7) and dyspnoea (n = 5). Concomitant disorders were bronchiectasis (44 %), diabetes (33 %) and hypertension (28 %). Multimodality and single-modality diagnostic strategies were applied in 56 % and 44 %, respectively. The origin of the CBFs was the left circumflex artery in 61 %, the right coronary artery in 36 % and the left anterior descending artery in 3 %. Management was conservative (22 %), surgical ligation (11 %), percutaneous transcatheter embolisation (30 %), awaiting lung transplantation (7 %) or not reported (30 %).ConclusionsCBFs may remain clinically silent, or present with chest pain or haemoptysis. CBFs are commonly associated with bronchiectasis and usually require a multimodality approach to be diagnosed. Several treatment strategies are available. This report presents two adult cases with CBFs and a review of the literature.

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“…Some advocate closure of coronary artery fistulae even in asymptomatic patients [4]. Shin et al [5] have proposed prophylactic and therapeutic embolization of coronary-bronchial artery fistula in patients with bronchiectasis. However, embolization, although less invasive, can be safely performed only after the anatomical relationships between the fistula and the surrounding structures are completely assessed.…”

Section: Discussionmentioning

confidence: 99%

Coronary Bronchial Steal

Ak¹,

Lodh²,

Sanyal³

et al. 2013

JCR

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Abstract:Background: Most patients with coronary-bronchial fistulas are asymptomatic. However, some patients present with congestive heart failure, infective endocarditis, myocardial ischemia induced by a coronary steal phenomenon, or rupture of an aneurysmal fistula. Our case of coronary-bronchial steal presented with massive hemoptysis and anginal pain. Methods: CT scan chest showed an emphysematous bulla and focal bronchiectatic changes involving right upper lobe. Coronary angiography revealed a large fistula connecting left circumflex coronary artery to right bronchial artery. A covered stent was placed in proximal left circumflex artery and collaterals excluded. Result: His angina resolved and dyspnea improved. Hemoptysis reduced from about 500 ml per day to about 50 ml a day, in ten days. 6-month follow-up has been uneventful without recurrence of angina or hemoptysis. Conclusion: This report highlights the importance coronary angiography in detecting coronary artery abnormalities in patients with hemoptysis. Although previously treated with surgical ligation, interventional therapies are justifiably becoming more widely used to correct vascular insufficiencies.

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Prophylactic and therapeutic embolization of coronary-bronchial artery fistula in patient with Bronchiectasis

Cited by 7 publications

References 9 publications

Coronary-Bronchial Artery Fistula Manifested by Hemoptysis and Myocardial Ischemia in a Patient with Bronchiectasis

Coronary-Bronchial Artery Fistula Manifested by Hemoptysis and Myocardial Ischemia in a Patient with Bronchiectasis

Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature

Coronary Bronchial Steal

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