Coronary-Cameral Fistula Caused by Guidewire Trauma and Resolved by Coil Embolization

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Device Complications

Background:

• A 57-year-old woman with critical two-vessel disease underwent percutaneous coronary intervention.
• Effort angina was the initial presenting symptom, necessitating coronary intervention.

Observation:

• During the angioplasty procedure, a guidewire inadvertently traversed the septal branches of the posterior descending coronary artery.
• This guidewire passage resulted in the formation of a coronary artery-to-right ventricular fistula.

Findings:

• The newly formed fistula was successfully managed and closed using percutaneous coil embolization.
• This represents the first reported case of a guidewire-induced coronary artery-to-right ventricular fistula treated with coil embolization.

Implications:

• Percutaneous coil embolization is a viable and effective treatment for guidewire-induced coronary artery-to-right ventricular fistulas.
• This case highlights a rare but manageable complication of percutaneous coronary intervention, emphasizing the importance of meticulous technique and awareness of potential guidewire-related issues.