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Large spontaneous coronary artery-to-right ventricular fistula

Brian Cabarrus1, Nazim U Khan, Rony L Shammas

  • 1Division of Cardiology, East Carolina University Brody School of Medicine, Greenville, Pitt County Memorial Hospital, Greenville, North Carolina 27834, USA.

The Journal of Invasive Cardiology
|January 2, 2007
PubMed

Insights

A rare left anterior descending artery to right ventricular fistula formed spontaneously. This unprovoked cardiac fistula was confirmed with angiography and surgery.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery fistulas are abnormal connections between a coronary artery and a cardiac chamber or vessel.
  • Spontaneous formation of these fistulas, particularly involving the left anterior descending artery and right ventricle, is exceedingly rare.

Observation:

  • A case presented with the spontaneous development of a left anterior descending artery (LAD) to right ventricular (RV) fistula.
  • The fistula's unprovoked appearance was meticulously documented through serial diagnostic angiography.
  • Surgical confirmation provided definitive evidence of the fistulous tract.

Findings:

  • The primary finding is the spontaneous, unprovoked occurrence of an arteriovenous fistula between the LAD and the RV.
  • Angiographic evidence demonstrated the anomalous connection, showing direct communication.
  • Intraoperative findings corroborated the presence and nature of the fistula.

Implications:

  • This case highlights a rare but potential complication or presentation within cardiovascular medicine.
  • Understanding spontaneous fistula formation is crucial for accurate diagnosis and surgical planning.
  • Further investigation may elucidate the underlying mechanisms driving such spontaneous vascular anomalies.

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