[Giant coronary artery fistula: Report of one case]
Héctor Ugalde1, Diego Ugalde2, Gastón Dussaillant2
1Departamento Cardiovascular, Hospital Clínico, Universidad de Chile, Chile, ugaldehector@gmail.com.
Insights
This case report details a 60-year-old woman with coronary artery fistula, an abnormal connection between a coronary artery and the heart. Surgical repair successfully treated her symptoms, with the patient remaining well five years post-operation.
Area of Science:
- Cardiology
- Vascular Surgery
- Congenital Heart Disease
Background:
- Coronary artery fistulae (CAF) are uncommon congenital or acquired abnormal vascular connections.
- They can lead to significant cardiovascular complications if left untreated.
Observation:
- A 60-year-old woman presented with progressive dyspnea and orthopnea.
- Physical examination revealed a continuous heart murmur.
- Echocardiography suggested a dilated right coronary artery with flow into the right atrium.
Findings:
- Coronary angiography confirmed a large, tortuous right coronary artery with extensive communication to the coronary venous sinus.
- The left coronary artery was normal.
Implications:
- Surgical correction of coronary artery fistulae can be highly effective in resolving symptoms.
- This case highlights the importance of timely diagnosis and intervention for CAFs, even in older adults.
- Successful surgical outcomes in CAF management can lead to long-term patient well-being.
Abstract:
Coronary artery fistulae are abnormal connections between a coronary artery and any cardiac chamber or other vessels. Most of them have a congenital origin. We report a 60 years old woman referring a history of progressive dyspnea and orthopnea during the last year. A continuous heart murmur was audible in the third and fourth intercostal spaces at the left sternal border. Electrocardiogram was normal and echocardiography showed mild dilation of right cavities and an image suggesting a dilated right coronary artery with flow to right atrium. Coronary angiography was performed, showing a normal left coronary artery and a very large, tortuous right coronary artery with an extensive communication to coronary venous sinus. Surgical treatment was decided and was performed without incidents. The patient is well after five years of follow up.
