Percutaneous closure of right coronary to superior vena cava fistula

Area of Science:

• Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Coronary artery to superior vena cava (SVC) fistula is an exceedingly rare congenital cardiac anomaly.
• These fistulas typically follow the sinoatrial-nodal branch and can arise from the right coronary or circumflex artery, often terminating near the right atrium-SVC junction.

Observation:

• A symptomatic patient with a right coronary artery to SVC fistula was treated.
• The case involved a unique percutaneous embolization strategy employing a guidewire loop and balloon occlusion technique.

Findings:

• Controlled access and embolization were achieved via a through-and-through guidewire, spanning from arterial to venous groin access.
• Detachable coils were deployed during coronary artery fistula balloon occlusion, successfully closing the fistula.

Implications:

• This case demonstrates the efficacy of a novel transcatheter embolization technique for managing coronary artery to SVC fistula.
• The described method provides a potentially valuable alternative for treating this rare condition, expanding interventional cardiology options.