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Multiple fistulae of coronary arteries to both ventricles
K Shiota1, M Kinoshita, N Kimura
1Congenital Anomaly Research Center, Faculty of Medicine, Kyoto University, Japan.
Insights
This study reports a rare case of multiple coronary arteriovenous fistulae in a 74-year-old man, a condition where coronary arteries abnormally connect to heart chambers. This finding offers insights into congenital cardiac anomalies.
Area of Science:
- Cardiovascular Pathology
- Congenital Heart Disease
- Embryonic Development
Background:
- Coronary artery anomalies are rare but can lead to significant cardiovascular complications.
- Understanding the embryological basis of these anomalies is crucial for diagnosis and management.
Observation:
- Necropsy revealed multiple coronary arteriovenous fistulae involving all major coronary arteries and both ventricles in a 74-year-old male.
- Terminal branches of coronary arteries were observed entering the myocardium, with numerous small vessels opening directly into cardiac chambers.
- Absence of normal coronary veins and coronary sinus was noted in the observed specimen.
Findings:
- The case represents the second reported instance of multiple coronary arteriovenous fistulae.
- The vascular anomaly is hypothesized to arise from the abnormal persistence of embryonic intertrabecular spaces within the myocardium.
- This suggests a developmental defect in the formation of the coronary vasculature and cardiac chambers.
Implications:
- This case highlights the importance of recognizing rare congenital cardiac malformations.
- Further research into the embryological origins of coronary arteriovenous fistulae may improve diagnostic strategies.
- Understanding such anomalies can inform surgical or interventional approaches for similar conditions.
Abstract:
A 74 year old man was found at necropsy to have multiple coronary arteriosystemic fistulae involving all three major coronary arteries and both ventricles. This is the second such case reported. All terminal branches of the coronary arteries entered the myocardium and numerous tiny vessels opened into the cardiac chambers. No coronary veins or coronary sinus were recognized. This vascular anomaly is considered to result from the abnormal persistence of intertrabecular spaces within the embryonic myocardium.