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Fistula between right coronary artery vein graft and right atrium as an immediate complication of percutaneous

Adel El Hosieny1, William Hui

  • 1CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, Alberta, Canada. a_hosieny@yahoo.com.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 12, 2012
PubMed

Insights

A rare fistula between a saphenous vein graft and the right atrium occurred after coronary artery bypass grafting intervention. A covered stent successfully closed the arteriovenous shunt, preventing long-term complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Fistula between saphenous vein graft (SVG) and cardiac chambers is a rare post-coronary artery bypass grafting (CABG) complication.
  • Percutaneous coronary intervention (PCI) is a common procedure for managing coronary artery disease.

Observation:

  • An 86-year-old female developed an immediate SVG-to-right atrium (RA) fistula post-PCI for an unsuccessful ST-elevation myocardial infarction treatment.
  • Cardiac magnetic resonance (CMR) confirmed the SVG-RA fistula and a significant arteriovenous (AV) shunt.
  • Anticoagulation reversal did not resolve the fistula.

Findings:

  • A covered stent effectively closed the SVG-RA fistula.
  • This intervention successfully managed the immediate post-procedural complication.

Implications:

  • This case highlights the diagnostic and management challenges of rare post-CABG/PCI complications.
  • Percutaneous techniques, such as covered stent deployment, offer effective solutions for SVG-cardiac chamber fistulas.
  • Early diagnosis and intervention can prevent serious long-term arteriovenous shunt sequelae.

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