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Complex coronary sinus fistula in a 58-year-old female

Ruth E Blackham1, Eric Yamen, Bernard E F Hockings

  • 1Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. r-hlc@blackham.com.au

Heart, Lung & Circulation
|May 3, 2008
PubMed

Insights

This case report details a large coronary artery aneurysm and arteriovenous fistula in a 58-year-old woman. Management strategies and prophylaxis for thrombotic complications are discussed, recommending warfarin and aspirin post-operatively.

Area of Science:

  • Cardiology
  • Vascular Malformations

Background:

  • Coronary artery aneurysms and arteriovenous fistulae are rare congenital or acquired conditions.
  • These malformations can lead to significant hemodynamic alterations and complications.

Observation:

  • A 58-year-old female presented with a large aneurysmal fistula originating from the left coronary artery.
  • The fistula involved the entire coronary sinus venous system, creating a substantial left-to-right shunt.

Findings:

  • The case highlights the complex management of coronary artery aneurysmal fistulae.
  • Discussion includes prophylaxis strategies to prevent thrombotic events in large aneurysms.

Implications:

  • Post-operative anticoagulation with warfarin and aspirin is recommended for patients with large coronary artery aneurysmal fistulae.
  • This approach aims to mitigate the risk of thromboembolic complications and improve patient outcomes.

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