Acquired coronary fistula after left ventricular de-airing by apical needle aspiration

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Cardiac Pathology

Background:

• Acquired coronary fistulas are infrequent, with documented cases following cardiac surgery, myocardial infarction, biopsies, angioplasty, and trauma.
• Coronary artery fistulas represent abnormal connections between a coronary artery and a cardiac chamber or vessel.

Observation:

• A rare case of a left coronary artery to left ventricular cavity fistula is presented.
• This fistula occurred subsequent to the surgical resection of a left atrial myxoma.

Findings:

• The fistula likely resulted from needle insertion into the left ventricular apex during the de-airing procedure.
• The coronary fistula demonstrated spontaneous closure within several weeks post-operatively.

Implications:

• This case highlights a potential complication of left ventricular de-airing techniques.
• Understanding the etiology and natural history of such fistulas is crucial for patient management.
• Further investigation into preventative measures for iatrogenic coronary fistulas may be warranted.