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A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail
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Coronary Arteriovenous Fistula Draining Into Persistent Left Superior Vena Cava
Tomohito Kanzaki1, Satoshi Numata1, Sachiko Yamazaki1
1Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
The Annals of Thoracic Surgery
|March 18, 2019
Summary
A rare coronary artery fistula draining into the persistent left superior vena cava caused heart failure in a 75-year-old woman. Surgical intervention successfully bypassed the fistula, but thrombosis progressed in the abnormal vessels.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Imaging
Background:
- Coronary artery fistulas are uncommon congenital or acquired abnormalities.
- Persistent left superior vena cava (PLSVC) is a rare congenital anomaly where the left superior vena cava does not regress during embryonic development.
Observation:
- A 75-year-old female presented with dyspnea and lower limb edema.
- Computed tomography angiography identified a dilated left coronary artery and a fistula draining into the PLSVC.
- Physical examination revealed pulmonary hypertension and congestive heart failure.
Findings:
- The patient underwent surgical closure of the fistula and coronary artery bypass grafting.
- Postoperative imaging confirmed graft patency.
- Thrombosis progressed within the dilated abnormal coronary vessels despite surgical intervention.
Implications:
- This case highlights a complex cardiovascular anomaly involving coronary artery fistula and PLSVC.
- Management requires careful consideration of surgical risks and potential postoperative complications.
- Further research may explore optimal long-term management strategies for such rare conditions.
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