Surgical management of the coronary artery to pulmonary artery fistulas; a case of a large ruptured aneurysm

Ishikura, Y; Odagiri, S; Shimazu, Akira; Hirao, Daigo; Watanabe, Hiroyuki; Yano, Kouichi

doi:10.1007/bf00311346

Cited by 8 publications

(11 citation statements)

References 11 publications

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“…In aneurysmal fistulas, thrombus propagation from the aneurysm, distal emboli and rupture with hemopericardium, and/or cardiac tamponade are the most serious complications. 20 A review of the literature has revealed 14 cases with aneurysmal fistulas associated with rupture leading to cardiac tamponade and/or sudden death [1][2][3][4][5][6][7][8][9][10][11][12][13][14] wherein the majority of these patients were diagnosed ante mortem by coronary arteriography (Table 1). This was confirmed during surgical intervention, by pathologic examination or displayed at autopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Two patients had a dual (bilateral) origin and single termination of the fistula. 13,14 The termination into the right heart side was found in 12 and to the left heart side in only 1 of the patients. In 1 patient the termination was not reported.…”

Section: Clinical Presentationmentioning

confidence: 97%

“…10 Pathologic Anatomy Pathological findings were mainly thrombus, aneurysm with wall destruction causing perforation and coronary artery atherosclerotic changes. 3,10,13,21 Histopathologic examination of the resected aneurysmal wall revealed neither signs of infectious process nor evidence of inflammation. 6,9 With the development of improved invasive and sophisticated noninvasive diagnostic methods, the premortem detection of CAFs, especially the asymptomatic ones, remains hitherto mostly undiagnosed until therapeutic intervention or postmortem.…”

Section: Autopsy Findingsmentioning

confidence: 99%

“…This search resulted in 14 published reports. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] The following criteria were stipulated in order to obtain a homogenous cohort of study: patients >18 years of age, clinical presentation, confirmation of diagnosis, findings of pathologic anatomy, and treatment modality.…”

Section: Literature Searchmentioning

confidence: 99%

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Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

Saïd

Schroeder‐Tanka

Mulder³

2008

Congenital Heart Disease

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Rupture of congenital aneurysmal fistulas occurred more often in females. Identified risk factors for rupture, hemopericardium, tamponade, and death were among others saccular aneurysm, Asian ethnic race, origin of the aneurysmal fistulas from the left coronary artery and a history of hypertension may play a role. In this article, we present a literature review of congenital aneurysmal fistulas associated with or without rupture and a case report of a woman with unruptured aneurysmal fistula.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 97%

Section: Autopsy Findingsmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

See 2 more Smart Citations

Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

Saïd

Schroeder‐Tanka

Mulder³

2008

Congenital Heart Disease

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“…7 there have been many reports of CAA concomitant with CAF, but those with rupture and cardiac tamponade are very rare. [8][9][10][11][12][13][14][15][16] We speculate that in the present case, congenital CAF were already extant and the CAA was secondary, probably as a result of the atherosclerotic changes of the walls of the CAF, because the patient did not have a history of chest trauma or have inflammatory symptoms similar to aortitis. It was rupture of the atherosclerotic aneurysm that resulted in cardiac tamponade.…”

Section: Discussionmentioning

confidence: 99%

Rupture of an Aneurysm Resulting From a Coronary Artery Fistula-A Case Report-

Akashi

Tayama

et al. 2003

Circ J

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A rare case of coronary-to-pulmonary artery fistulas associated with formation of a saccular aneurysm that ruptured into the pericardium occurred in a 69 year-old-female who had experienced an episode of unconsciousness 3 months earlier and who suffered a second episode. She was diagnosed as having a cardiac tamponade caused by rupture of a coronary artery aneurysm formed by a left coronary artery - pulmonary artery fistula. The hemorrhage stopped after pericardial drainage. She was referred for surgical treatment of the aneurysm and suture closure of the afferent coronary artery into the aneurysm, transpulmonary closure of the fistulas, and aneurysmorrhaphy. There was adhesion between the aneurysm and pericardium. Her postoperative course was uneventful and she has remained well for 4 months after the operation.

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Coronary Arterial Fistula

2009

The Natural and Unnatural History of Congenital Heart Disease

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Congenital coronary artery fistula is a rare abnormality in which a branch of either coronary artery communicates with a cardiac chamber or with the pulmonary trunk. Recently Papaioannou and his colleagues (1962) reviewed 70 adequately documented cases, including one of their own; in 18 of these a branch of the right coronary artery entered the right ventricle. A further patient with this anomaly is described here, with observations on the problem of diagnosis and a possible surgical approach to the correction of the lesion. Case ReportA man, aged 31 when he died, was first seen at this hospital in 1957 six years previously, when he was admitted for a hernia operation. He had been attending a physician elsewhere and was known to have congenital heart disease, which was then symptomless. At no time did he have a continuous murmur.On examination, he had a collapsing pulse with capillary pulsation and a wide pulse pressure (blood pressure 150/45 mm. Hg). There was no cyanosis or clubbing and the venous pressure was normal. The heart was very large with hypertrophy of both ventricles. There was a very loud pan-systolic murmur, with thrill, maximal in the third intercostal space to the left of the sternum, an apical mid-diastolic murmur, and a soft blowing early-diastolic murmur down the left border of the sternum. The second sound was normally split. The electrocardiogram showed left ventricular hypertrophy, without ST or T wave changes but with notching of the R wave in leads I and V6 (Fig. la). On the chest radiograph there was enlargement of aorta and pulmonary trunk, and considerable pulmonary plethora. At cardiac catheterization, a large left-toright shunt at ventricular level was demonstrated (pulmonary/systemic flow ratio approximately 4:1), the pulmonary arterial pressure was slightly raised (35/7 mm. Hg above the sternal angle), and the pulmonary vascular resistance was normal. He was thought to have a ventricular septal defect with aortic regurgitation, but the discrepancy between the width of the pulse pressure and the inconspicuous early diastolic murmur was noted. Operation was not advised as he was then symptomless and as the presence of presumably free aortic reflux would have posed problems which at that time were insuperable.He was not seen again until five years later when he returned with increasing effort dyspncea and palpitation, and was found to have atrial fibrillation, with clinical and radiological evidence of pulmonary congestion. The signs were otherwise unchanged (phonocardiogram shown in Fig. lc), but the electrocardiogram now showed evidence of right ventricular hypertrophy (Fig. lb). The blood pressure was 170/30 mm. Hg. In spite of treatment his condition deteriorated, and he was readmitted to hospital with right and left ventricular failure, pulmonary infarction, and secondary chest infection. He never improved sufficiently for further investigations to be undertaken, and he died in May 1963.At necropsy (Dr. W. J. Hanbury) there was peripheral cedema, with pleural, pericardial, and p...

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Surgical management of the coronary artery to pulmonary artery fistulas; a case of a large ruptured aneurysm

Cited by 8 publications

References 11 publications

Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

Female Gender and the Risk of Rupture of Congenital Aneurysmal Fistula in Adults

Rupture of an Aneurysm Resulting From a Coronary Artery Fistula-A Case Report-

Coronary Arterial Fistula

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