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Atypical chest pain due to multiple coronary arteries fistulas occluded with percutaneous interlock coils: A case

Gustavo Iacomini Ida1, Michel A Kalansky1, Luciana de Pádua S Baptista1

  • 1Samaritano Paulista Hospital, Sao Paulo, Brazil.

Journal of Cardiology Cases
|January 13, 2021
PubMed

Insights

Multiple coronary fistulas causing chest pain and ischemia were successfully treated using novel interlock fibered detachable coils. This minimally invasive approach offers a safe alternative for complex cases, even with tortuous anatomy.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary artery fistulas are rare but should be considered in atypical chest pain.
  • Significant ischemia and severe symptoms necessitate fistula closure.

Observation:

  • A case of multiple coronary-bronchial fistulas presenting with atypical chest pain and substantial ischemia was observed.
  • The patient had a history of thromboembolism, adding complexity to treatment considerations.
  • The fistulas exhibited tortuous anatomy, posing a challenge for intervention.

Findings:

  • Transcatheter closure using novel interlock fibered detachable coils was successfully performed.
  • This represents the first reported use of this device for multiple tortuous coronary-bronchial fistulas.
  • The procedure was safe and effective, resolving the patient's symptoms and ischemia.

Implications:

  • Novel devices like interlock fibered detachable coils provide a safe and effective transcatheter alternative to surgery for coronary fistulas.
  • This approach is feasible even in complex anatomies, such as tortuous coronary arteries.
  • The findings support the use of these devices for symptomatic patients with documented ischemia due to coronary fistulas.

Keywords:
Coronary fistulaInterlock coilThromboembolismTranscatheter

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