Ruptured Giant Coronary Artery Aneurysm With Coronary Artery to Pulmonary Artery Fistula Presenting as Cardiac Tamponade Diagnosed by Intraoperative Transesophageal Echocardiography: A Case Report

Chiricolo, Antonio; Pantin, Enrique J.; Raffel, Brian; Lemaire, Anthony; Lee, Leonard Y.

doi:10.1213/xaa.0000000000000740

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…The risk of rupture of aneurysms of all sizes increases in a size‐dependent manner. For patients with obvious CAA symptoms, timely surgery is necessary 26–30 . Even if conservative treatment is chosen, strict follow‐up is also necessary, and the risk of life‐threatening rupture still exists.…”

Section: Discussionmentioning

confidence: 99%

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CTA analysis of 482 cases of coronary artery fistula: A large‐scale imaging study

Cai

Zhao

et al. 2022

Journal of Cardiac Surgery

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Objective The prevalence of coronary artery fistula (CAF) based on coronary angiography has been reported. However, with the popularity of coronary computerized tomography angiography (CTA), CAFs have been found more and more by chance. The purpose of this study was to determine the prevalence and types of CAFs detected by coronary CTA, and to explore the differences in the size of fistulas, the number of complicated aneurysms, and fistulas among different types. Materials and Methods From January 2016 to December 2020, 96,037 patients underwent coronary CTA in our hospital. The prevalence of CAF was retrospectively evaluated, The origin, course, and drainage site of CAF and coexisting abnormalities were analysed. The conventional treatments and follow‐up DSCT images were also evaluated. Analyze the difference between the coronary‐pulmonary artery fistula (CPAFs) group (380) and the coronary‐cameral fistula (CCF) group (99). Results Among 96,037 patients, 482 (0.5%) patients (male 232 and 250 female) had CAF. The types of CAF detected. The pulmonary artery was the most common site of drainage (380/482, 78.8%). Of the 99 CCFs, coronary to the left ventricle is the most common pattern in CCF (34/482, 7.0%). Single origins are more common in CAF (n = 361, 74.9%), multiple origins are more common in CPAFs than in CCF. There were statistically significant differences in the stoma diameter (2.4 ± 1.1 mm vs. 5.4 ± 4.3 mm p < .05), aneurysm complicated (85 cases [85/380] vs. 50 cases [50/99]), the size of aneurysm (8.8 ± 5.7 mm vs. 19.1 ± 11.6 mm, p < .05), and single fistula (261 [261/380] vs. 96 [96/99], p < .05). Most of the 380 CPAFs patients received conservative treatment (350/380, 92.1%), While the 59 CCF patients (59/93, 63.4%) were treated. Conclusions Different from previous reports, the prevalence of CAF in coronary CTA is 0.5%, the incidence of CPAFs is the highest, and the incidence of the left ventricular fistula is higher in CCF. Compared with CPAFs, CCF fistulas were more likely to be associated with a larger diameter of draining, larger aneurysms, single fistula pattern. Coronary artery CTA is a useful and noninvasive imaging method to detect CAF, which is of great significance for the detection of small fistulas and the surgical guidance of complex CAF.

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Section: Discussionmentioning

confidence: 99%

“…For patients with obvious CAA symptoms, timely surgery is necessary. [26][27][28][29][30] Even if conservative treatment is chosen, strict follow-up is also necessary, and the risk of life-threatening rupture still exists.…”

Section: The Differences Between Cpafs and Ccfmentioning

confidence: 99%

CTA analysis of 482 cases of coronary artery fistula: A large‐scale imaging study

Cai

Zhao

et al. 2022

Journal of Cardiac Surgery

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“…CAF without symptoms are usually not considered an indication for surgical treatment. However, in recent years there have been several case reports of ruptured aneurysm in CAF that underwent surgery [4][5][6][7]. Rittenhouse et al advocated that a large shunt flow (average Qp/Qs = 2.0) and symptoms of heart failure are justified indications for surgery, but left-toright shunt flow is usually low (average Qp/Qs = 1.5) and coronary artery steal syndrome is rare [8].…”

Section: Discussionmentioning

confidence: 99%

Giant Aneurysm of Coronary Artery Fistula Successfully Treated by Surgical Repair

Harada

Mori²,

Mori³

et al. 2020

Cureus

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An asymptomatic 65-year-old woman was identified with an oversized round-shaped hypoechoic lesion (62 mm in diameter) between right and left atria by echocardiogram. A contrast-enhanced 320-slice multidetector computed tomography demonstrated a giant aneurysmatic fistula branched from the left main coronary trunk towards right atrium. The patient underwent an elective surgical repair. The aneurysm was resected, followed by coronary artery bypass graft surgery using bilateral internal thoracic arteries. The surgery was successful, and the patient enjoys normal life without any symptoms for 15 months.

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Ruptured Giant Coronary Artery Aneurysm With Coronary Artery to Pulmonary Artery Fistula Presenting as Cardiac Tamponade Diagnosed by Intraoperative Transesophageal Echocardiography: A Case Report

Cited by 2 publications

References 7 publications

CTA analysis of 482 cases of coronary artery fistula: A large‐scale imaging study

CTA analysis of 482 cases of coronary artery fistula: A large‐scale imaging study

Giant Aneurysm of Coronary Artery Fistula Successfully Treated by Surgical Repair

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