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Coronary fistulas: a case series
Fennich Nada1, Elouali Fedoua1, Saghi Ghita1
1Department of Cardiology B, Ibn Sina Hospital, Rabat, Morocco. Personnel address: R»sidence Arsat al Mahata immeuble E7 n∞ 8 Tabriquet, Sal», Maroc.
Insights
Congenital coronary artery fistulas are rare and present uniquely in patients. Management varies, often depending on symptom development.
Area of Science:
- Cardiology
- Radiology
Background:
- Coronary artery fistulas are uncommon congenital anomalies.
- Diagnosis is typically incidental during angiographic examinations.
Observation:
- A case series of five patients with congenital coronary fistulas is presented.
- Patients varied in age (12-57 years) and had diverse associated cardiac conditions.
- These included atrioventricular defects, atherosclerotic disease, mitral stenosis, and bronchial artery communication.
Findings:
- The study highlights the varied angiographic appearances of coronary fistulas.
- Associated conditions ranged from congenital defects to acquired diseases.
- One patient presented with bilateral fistulas and aneurysmal dilatation.
Implications:
- The diverse presentations underscore the complexity of congenital coronary fistulas.
- Management strategies require individualized consideration based on clinical presentation.
- Further research may clarify optimal treatment pathways for symptomatic and asymptomatic cases.
Abstract:
Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms.
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