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Coronary artery fistula with left or right ventricular communication and sinus-node dysfunction
R Endoh1, T Maruyama, K Akahane
1The Department of Cardiology, Showa Inan General Hospital, Komagane-shi, Japan.
Texas Heart Institute Journal
|January 1, 1990
Summary
Congenital coronary artery fistulae connecting to the left ventricle are rare, especially when combined with sinus-node dysfunction. These cases suggest a steal syndrome from the fistulae may cause this unusual cardiac condition.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Electrophysiology
Background:
- Coronary artery fistulae (CAF) are abnormal connections between coronary arteries and heart chambers.
- CAF communicating with the left ventricle (LV) are exceptionally rare.
- Co-occurrence of CAF with sinus-node dysfunction (SND) is even more unusual.
Purpose of the Study:
- To report two rare cases of congenital coronary artery fistulae with left ventricular communication and sinus-node dysfunction.
- To explore the potential link between coronary artery fistulae and sinus-node dysfunction.
Main Methods:
- Case report of two patients presenting with congenital coronary artery fistulae and sinus-node dysfunction.
- Detailed clinical evaluation, including anatomical assessment of fistulae and electrophysiological studies.
Main Results:
- Two patients presented with congenital coronary artery fistulae originating from both left and right coronary arteries, communicating with the left ventricle.
- One patient also had a right coronary artery fistula communicating with the right ventricle.
- Sinus-node dysfunction was observed in both patients, likely secondary to chronic ischemia caused by a steal syndrome from the fistulae.
Conclusions:
- Congenital coronary artery fistulae to the left ventricle, particularly when associated with sinus-node dysfunction, represent a rare clinical entity.
- A steal syndrome resulting from these fistulae may be the underlying mechanism for the observed sinus-node dysfunction.