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An elephant trunk appearance-what is the diagnosis?

Roopali Khanna1, Deepchandh Raja2, Pravin K Goel2

  • 1Department of Cardiology, Sanjay Gandhi PostGraduate Institute of Medical Sciences, Lucknow, India. drroopalik@gmail.com.

Echocardiography (Mount Kisco, N.Y.)
|October 27, 2016
PubMed

Insights

A rare congenital heart defect, coronary cameral fistula, was successfully treated in an 18-year-old boy. Transcatheter closure using an Amplatzer vascular plug resolved the right heart volume overload caused by this coronary artery anomaly.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Coronary cameral fistula is a rare congenital cardiac abnormality.
  • Presents with symptoms of right heart volume overload and characteristic murmurs.

Observation:

  • An 18-year-old male presented with hyperdynamic circulation and a continuous precordial murmur.
  • Echocardiography revealed a dilated right coronary artery and a fistula draining into the right ventricle.
  • Coronary angiography showed an "elephant trunk" appearance of the right coronary artery and the fistulous tract.

Findings:

  • Diagnosis of right coronary cameral fistula confirmed.
  • Successful transcatheter closure of the fistula was achieved using an Amplatzer vascular plug.
  • This minimally invasive approach was chosen due to surgical risks.

Implications:

  • Transcatheter closure is a safe and effective alternative to surgery for coronary cameral fistulas.
  • 3D echocardiography aids in precise fistula tract visualization.
  • Successful management of this rare anomaly improves patient outcomes.

Keywords:
Amplatzer vascular plugcontinuous murmurcoronary cameral fistulamassive cardiomegaly

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