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Coronary arteriovenous fistula with annuloaortic ectasia and aortic regurgitation

T Kono1, H Kitahara, H Kuroda

  • 1Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|March 22, 2001
PubMed

Insights

A rare left coronary artery-coronary sinus fistula was identified in a patient with annuloaortic ectasia and severe aortic regurgitation. Surgical repair involved direct closure and ligation, followed by a successful modified Bentall procedure.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Congenital Heart Disease

Background:

  • Coronary artery fistulas are uncommon congenital or acquired cardiovascular anomalies.
  • Annuloaortic ectasia and severe aortic regurgitation necessitate complex surgical management.
  • Left coronary artery-coronary sinus fistulas present unique diagnostic and therapeutic challenges.

Observation:

  • Cardiac catheterization revealed a left coronary artery-coronary sinus fistula in a 57-year-old male.
  • The patient also exhibited annuloaortic ectasia and severe aortic regurgitation.
  • Surgical exposure and clamping of the fistula preceded cardioplegic infusion.

Findings:

  • Successful direct closure of the proximal fistula orifice and double ligation of the distal orifice.
  • A modified Bentall's procedure was performed without complications.
  • The patient experienced an uneventful postoperative recovery.

Implications:

  • This case highlights successful surgical management of a complex coronary artery fistula combined with aortic disease.
  • Effective surgical techniques can address both the fistula and the underlying aortic pathology.
  • Optimal patient outcomes are achievable with meticulous surgical planning and execution.

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