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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Coronary arteriovenous fistula between left circumflex artery and superior vena cava

Sanjeev Kumar Khulbey1, Sanjay Agarwal2, Vijay Dikshit2

  • 1Department of Cardiothoracic Surgery, Apollo Hospital, Hyderabad, India khulbeycvts@yahoo.co.in.

Interactive Cardiovascular and Thoracic Surgery
|June 3, 2015
PubMed

Insights

A 52-year-old man with double-vessel coronary artery disease and a coronary artery fistula underwent successful off-pump coronary artery bypass grafting. This surgical approach effectively managed his symptoms and closed the abnormal vessel connection.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality worldwide.
  • Coronary artery fistulas are rare congenital or acquired abnormalities.
  • Large fistulas can lead to significant hemodynamic alterations and myocardial ischemia.

Observation:

  • A 52-year-old male presented with exertional angina and dyspnea.
  • Diagnostic workup revealed double-vessel coronary artery disease.
  • A large fistula between the left circumflex artery and the superior vena cava was identified.

Findings:

  • The patient underwent successful off-pump coronary artery bypass grafting (OPCABG).
  • The coronary artery fistula was surgically closed during the procedure.
  • Postoperative recovery was uneventful, with symptom resolution.

Implications:

  • Off-pump CABG is a viable option for complex CAD with concomitant fistulas.
  • Surgical closure of large coronary artery fistulas can effectively relieve ischemic symptoms.
  • This case highlights the importance of identifying and managing rare coronary anomalies in patients with CAD.

Keywords:
Coronary fistula

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