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Coronary arteriovenous fistula with papillary muscle rupture

J Ahmed1, Y Edelstein, M Rose

  • 1Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.

Southern Medical Journal
|July 6, 2000
PubMed

Insights

A patient experienced mitral valve papillary muscle rupture due to a coronary arteriovenous fistula (CAVF). Surgical repair involved fistula ligation, bypass grafting, and valve replacement, marking the first reported case of CAVF-related rupture.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Surgery

Background:

  • Coronary arteriovenous fistula (CAVF) is a rare anomaly where coronary arteries connect directly to cardiac chambers or veins.
  • Chronic ischemia can result from a coronary steal phenomenon, where blood is diverted away from myocardial tissue.

Observation:

  • A patient presented with a coronary arteriovenous fistula (CAVF) causing chronic myocardial ischemia.
  • This ischemia led to the rupture of a mitral valve papillary muscle.

Findings:

  • The patient underwent successful surgical intervention, including ligation of the left circumflex to coronary sinus CAVF.
  • Coronary artery bypass grafting and mitral valve replacement were also performed.

Implications:

  • This case represents the first documented instance of papillary muscle rupture directly linked to a coronary arteriovenous fistula.
  • Highlights the potential for severe ischemic complications from CAVF and the importance of timely surgical management.

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