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Iatrogenic ST elevation during percutaneous closure of a coronary artery fistula

Nicholas Collins1, Lee N Benson, Eric M Horlick

  • 1Toronto Congenital Cardiac Centre for Adults, Department of Cardiology, University Health Network/Toronto General Hospital, Toronto, Ontario, Canada. nicholas.collins@hnehealth.nsw.gov.au

Congenital Heart Disease
|June 28, 2011
PubMed

Insights

This study details a rare electrocardiogram (ECG) abnormality during coronary artery fistula closure using detachable coils. The findings highlight a unique procedural complication without actual coronary artery injury.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Coronary artery fistulae are uncommon congenital or acquired abnormalities.
  • Transcatheter closure is a common interventional therapy for symptomatic fistulae.
  • Detachable coils are frequently used for fistula occlusion.

Observation:

  • A patient undergoing percutaneous closure of a left anterior descending coronary artery to pulmonary artery fistula experienced chest discomfort and anterior ST segment elevation.
  • This ECG abnormality occurred during coil delivery for fistula occlusion.

Findings:

  • The study demonstrates a unique and striking ECG abnormality during coil-based coronary artery fistula closure.
  • The observed changes were not associated with coronary artery injury.
  • Mechanisms for the procedural ECG changes are discussed.

Implications:

  • Understanding this rare ECG manifestation is crucial for interventional cardiologists.
  • It aids in differentiating procedural artifact from acute coronary syndromes.
  • This knowledge can guide appropriate patient management during fistula interventions.

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