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Dilated cardiomyopathy caused by a coronary-pulmonary fistula treated successfully with coil embolization

Hangyuan Guo1, Bingquan You, Jong-Dae Lee

  • 1Department of Cardiology, Shaoxing People's Hospital, The First Affiliated Hospital of Medical College, Shaoxing University, Shaoxing, China. ghangyuan@hotmail.com

Circulation Journal : Official Journal of the Japanese Circulation Society
|August 29, 2006
PubMed

Insights

A rare cause of dilated cardiomyopathy (DCM) in adults with normal coronary arteries, a coronary-pulmonary fistula leading to myocardial ischemia, was successfully treated. Percutaneous coil embolization offers a low-risk alternative to surgery for this condition.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
  • Coronary artery anomalies, such as fistulae, are uncommon but can lead to myocardial ischemia.
  • The coronary steal phenomenon can exacerbate ischemia in patients with coronary artery anomalies.

Observation:

  • A case of DCM was identified in an adult with normal coronary arteries.
  • The DCM was attributed to a coronary-pulmonary fistula causing myocardial ischemia via the coronary steal phenomenon.
  • The patient's condition was successfully managed without surgical intervention.

Findings:

  • Percutaneous coil embolization effectively treated the coronary-pulmonary fistula.
  • This intervention resolved the myocardial ischemia and improved the DCM.
  • The coronary steal phenomenon was mitigated by occluding the fistula.

Implications:

  • Coronary fistulae and associated coronary steal are rare but treatable causes of DCM.
  • Percutaneous treatment is a viable, low-risk alternative to surgery for such cases.
  • Clinical and anatomical factors should guide the choice between percutaneous and surgical interventions.

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