Transcatheter coil embolization of iatrogenic coronary artery–left ventricle fistula after mitral valve replacement

Abstract

Acquired causes of coronary fistulas are rare disorders and may develop following coronary atherosclerosis, infection, or trauma (iatrogenic). Iatrogenic coronary fistulas may be acquired secondary to surgical or nonsurgical interventions. We describe a case of an iatrogenic coronary artery-left ventricle fistula following mitral valve replacement surgery, presented with ventricular arrhythmia and heart failure. In a unique technique, we implanted three coils with the aid of a Scepter C balloon with inflation at the ostial portion of the left circumflex artery.

Spontaneous closure of an iatrogenic coronary artery fistula during recanalization of a chronic total occlusion lesion

“…Close observation and re-evaluation by echocardiography or CTA are helpful to choose appropriate management strategies, avoiding unnecessary cover stent implantation or coil embolization therapy. If the large iatrogenic coronary-cameral shunt causes myocardial ischemia symptom or heart failure, it should be treated either with percutaneous transcatheter embolization techniques [19–21] or when the anatomy is not amenable, the surgical ligation method could be utilized.…”