Percutaneous transcatheter device closure of coronary arteriovenous fistula through persistent left superior vena...

Area of Science:

• Cardiology
• Congenital Heart Disease
• Interventional Cardiology

Background:

• Congenital coronary artery fistula (CCAF) is a rare cardiac malformation with debated management in asymptomatic cases.
• Symptomatic CCAFs are typically managed with surgical or percutaneous closure.
• This case focuses on the interventional management of an asymptomatic, aneurysmally dilated coronary fistula.

Observation:

• A rare case of a coronary artery fistula originating from the circumflex artery and draining into the coronary sinus was identified.
• The patient possessed a persistent left superior vena cava (PLSVC), an uncommon venous anomaly.
• The fistula was aneurysmally dilated, posing potential risks despite being asymptomatic.

Findings:

• Successful percutaneous transcatheter device closure of the coronary artery fistula was achieved.
• The presence of a persistent left superior vena cava facilitated the procedure, simplifying access and closure.
• The intervention resulted in short procedural and fluoroscopy times, indicating efficiency.

Implications:

• This case highlights the feasibility and safety of percutaneous closure for complex coronary artery fistulas.
• Persistent left superior vena cava can be a beneficial anatomical variant for transcatheter interventions involving coronary fistulas.
• Percutaneous closure offers a minimally invasive option, potentially reducing morbidity compared to surgery, even in complex cases.