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Coronary-pulmonary artery fistula arising distal to obstructive coronary lesions
1Department of Cardiology, Royal Melbourne Hospital, Victoria, Australia.
Insights
Two cases of coronary-pulmonary artery fistulae (CPF) were successfully treated. These rare vascular abnormalities arose distal to coronary artery blockages and were surgically corrected during bypass grafting.
Area of Science:
- Cardiology
- Vascular Surgery
- Thoracic Medicine
Background:
- Coronary-pulmonary artery fistulae (CPF) are rare congenital or acquired cardiovascular anomalies.
- Obstructive coronary artery disease can rarely lead to the development of acquired CPFs.
Observation:
- The first case involved a tortuous dilatation of the distal right coronary artery forming a fistula into the right pulmonary artery.
- The second case presented a fistula, a plexus of vessels, originating from the left anterior descending artery and entering the left pulmonary artery.
Findings:
- Both reported CPFs arose distal to significant obstructive coronary artery disease.
- Surgical ligation of both fistulae was successfully performed concurrently with coronary artery bypass graft (CABG) surgery.
Implications:
- This report highlights the possibility of acquired CPFs in the context of severe coronary artery disease.
- Simultaneous surgical correction of CPFs during CABG is a feasible and effective treatment strategy.
- Further investigation into the pathogenesis and optimal management of acquired CPFs is warranted.
Abstract:
We report 2 cases of coronary-pulmonary artery fistulae (CPF) arising distal to obstructive coronary artery disease. The fistula in the first patient was in the form of a tortuous dilatation of the distal portion of the right coronary artery and opened into the right pulmonary artery. In the second case, the fistula, a plexus of vessels, arose from the left anterior descending artery and entered the left pulmonary artery. Both the fistulae were successfully ligated at the time of concurrent coronary artery bypass graft surgery.