An interventional percutaneous approach of posttraumatic left coronary artery fistula repair
Milosz Jaguszewski1, Dariusz Ciecwierz, Andrzej Rynkiewicz
1First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland. milosz.jaguszewski@usz.ch
Insights
A traumatic coronary artery fistula, a rare injury, occurred after a stabbing. It was successfully treated with a stent-graft, avoiding repeat surgery for this cardiac complication.
Area of Science:
- Cardiology
- Cardiac Surgery
- Trauma Management
Background:
- Traumatic coronary artery fistulas are rare cardiac injuries.
- Prompt surgical repair is crucial for managing penetrating chest trauma.
Observation:
- A 39-year-old man presented with a stab wound, undergoing emergency sternotomy for left lung and right ventricle repair.
- Postoperatively, he developed an acute anterior wall myocardial infarction.
Findings:
- Coronary angiography identified a fistula between the left anterior descending coronary artery and the right ventricle.
- The fistula was successfully treated with a stent-graft, a minimally invasive approach.
Implications:
- Stent-graft placement offers a viable alternative to re-operation for traumatic coronary artery fistulas.
- This case highlights the importance of recognizing and managing delayed cardiac complications after trauma.
Abstract:
We present an interesting case on the management of a traumatic coronary artery fistula in a 39-year-old man who was stabbed by his wife. During emergency sternotomy, left lung and right ventricle injuries were repaired. On the second postoperative day, an acute myocardial infarction of the anterior wall was recognized. Coronary angiography revealed a rare case of a fistula between the left anterior descending coronary artery and the right ventricle of the heart, which was treated by a stent-graft to avoid a re-operation.
