Successful treatment of a dilated circumflex artery and coronary sinus fistula
Alexander Martin Bernhardt1, Helmut Gulbins1, Hermann Reichenspurner1
1Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
Insights
Coronary arteriovenous fistula, a rare condition, is typically found in children. This case highlights a successful surgical correction in a 59-year-old woman presenting with exertional chest pain.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Case Reports
Background:
- Coronary arteriovenous fistula (CAVF) is a rare congenital or acquired anomaly.
- Most CAVFs are diagnosed and treated in infancy or early childhood.
- Adult presentation of CAVF, especially with coronary sinus involvement, is uncommon.
Purpose of the Study:
- To report a rare case of adult-onset coronary arteriovenous fistula.
- To describe the clinical presentation and successful surgical management of a complex CAVF in an adult.
- To emphasize the importance of considering rare cardiac anomalies in adult patients with atypical symptoms.
Main Methods:
- Surgical ligation of the aneurysmatic circumflex artery and coronary sinus fistula.
- Revascularization of the first marginal branch using the left internal thoracic artery.
- Detailed clinical assessment and intraoperative findings.
Main Results:
- Successful surgical correction of the coronary arteriovenous fistula.
- Resolution of exertional chest pain in the patient.
- Uneventful postoperative recovery.
Conclusions:
- Coronary arteriovenous fistula can present in adulthood with symptoms like exertional chest pain.
- Surgical intervention, including ligation and revascularization, can be effective in treating adult CAVF.
- This case underscores the need for a broad differential diagnosis in adult cardiology.
Abstract:
Coronary arteriovenous fistula is a rare entity and is mostly diagnosed and corrected in early childhood. We report the case of a 59-year-old female patient who was presented with chest pain during exertion for 3 months because of an aneurysmatic circumflex artery and coronary sinus fistula. We successfully ligated the circumflex artery close to the main stem and to the coronary sinus. The first marginal branch was revascularized by the left internal thoracic artery. The postoperative course was uneventful.
