Coronary Artery Fistula Ligation Using Selective Coronary Artery Angiography
Layla Shanah1, Orazio Amabile2, Sohaip Kabashneh1
1Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, USA.
Insights
This case study highlights the successful surgical closure of multiple coronary artery fistulas using intraoperative angiography. Intraoperative imaging aids in precisely ligating these complex vascular abnormalities.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Imaging
Background:
- Coronary artery fistulas are rare congenital or acquired abnormal connections between a coronary artery and a cardiac chamber or great vessel.
- Coronary steal phenomenon can lead to myocardial ischemia, presenting as shortness of breath.
Observation:
- A 55-year-old male presented with worsening dyspnea due to multiple coronary artery fistulas causing coronary steal.
- Coronary angiography confirmed the presence of fistulas and the steal phenomenon.
Findings:
- Successful surgical ligation of three coronary artery fistulas was achieved in a hybrid suite.
- Intraoperative coronary angiography was crucial for identifying fistulas and confirming successful closure.
Implications:
- This case supports the utility of intraoperative angiography in managing complex coronary artery fistulas.
- Further research is warranted to establish formal recommendations for intraoperative imaging in such procedures.
Abstract:
A 55-year-old male presented with worsening shortness of breath and was found to have multiple coronary artery fistulas on coronary angiogram with coronary steal. He subsequently underwent successful ligation of three of the fistulas using intraoperative coronary angiography in the hybrid suite to assist with the identification and confirmation of closure. There are currently no formal recommendations for the use of intraoperative imaging in such cases, but the results of our case contribute to the sparse body of literature supporting the utilization of intraoperative angiography in ligating multiple coronary artery fistulas.
