Case ReportPercutaneous Transcatheter Embolization of Coronary Arteriovenous Fistulas
Section snippets
REPORT OF CASES
Case 1.—A 24-year-old woman was referred to Mayo Clinic Rochester for management of a fistula between the left anterior descending coronary artery and the left ventricle. She had been stabbed in the left side of the chest and abdomen 18 months earlier and was experiencing electromechanical dissociation when she arrived at the local emergency department. Emergency left lateral thoracotomy revealed a penetrating wound to the right ventricle; after this was sutured, the patient's condition
DISCUSSION
Coronary arteriovenous fistulas are uncommon direct communications between a coronary artery and the coronary sinus, a cardiac vein, a pulmonary artery, the superior vena cava, a pulmonary vein, or one of the four cardiac chambers. Most patients are asymptomatic and have no associated cardiac anomalies; the fistulas are discovered incidentally or the patient is referred to a tertiary center because of a cardiac murmur.5 Serious complications of untreated fistulas can occur; therefore, most
CONCLUSION
Coronary artery fistulas are infrequently encountered vascular anomalies that pose challenges to those who perform angiography. Although most patients with these malformations are asymptomatic, serious late complications can develop, and elective ligation of the fistula is recommended by most investigators. Although surgical ligation is effective, perioperative mortality rates are between 2 and 4%. An operation has a high associated risk for elderly patients with comorbid conditions who have
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2008, International Journal of CardiologyCitation Excerpt :There were advances in interventional techniques as well as cardiac imaging over the last decade. Although interventionalist could attempt to treat CAVF by percutaneous transcatheter embolization, it is not always a simple procedure without risks and the treatment efficacy in our patient remains unknown [5]. Cardiac MRI could provide robust information in a few ways.
Management of coronary artery fistulae: Patient selection and results of transcatheter closure
2002, Journal of the American College of CardiologyCitation Excerpt :Since its introduction in 1983 (6), TCC of these lesions is increasingly being utilized as an alternative to surgical closure. Excluding single case reports, TCC of CAF has been reported in 45 patients (5 weeks to 71 years of age; median, 12 years) since 1982 (4,7–13,15)(Table 2). The data from our previously published report (14)are included in our current patient group.
Congenital Heart Surgery Nomenclature and Database Project: Anomalies of the coronary arteries
2000, Annals of Thoracic SurgeryCitation Excerpt :They are visualized in 1 of 500 patients undergoing catheterization (0.2% to 0.25%). They are the most common of hemodynamically significant coronary lesions [26–31], and comprise nearly half of all coronary artery anomalies [32]. They may be congenital or acquired (traumatic, infectious, or iatrogenic).
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Current address: Hampton Roads Cardiovascular Associates, Riverside Hospital, Newport News, Virginia.