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Complex cardiac vascular malformation: Natures own CABG
Shah Omair1, Choh Naseer1, Shera Faiz1
1Department of Radiology, SKIMS SOURA, J&K, India.
Insights
True cardiac arteriovenous malformations are rare vascular anomalies. This case highlights a large, complex malformation with extensive systemic, coronary, and pulmonary connections, demonstrating that intervention may not always be necessary.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Medical Imaging
Background:
- Cardiac arteriovenous malformations (AVMs) are uncommon congenital or acquired vascular anomalies.
- Multi-detector computed tomography (MDCT) offers superior visualization of these anomalies compared to invasive angiography.
Observation:
- A case study of a 55-year-old male with a large, complex cardiac vascular malformation is presented.
- The malformation involved feeders from the systemic (internal mammary artery, right inferior phrenic artery), coronary (left anterior descending), and pulmonary arterial and venous systems.
- A 64-slice MDCT scanner was utilized for detailed imaging.
Findings:
- This case is unique due to the malformation's large size and extensive involvement of multiple vascular systems.
- Despite the complexity, the patient presented with mild clinical symptomatology.
- MDCT effectively demonstrated the intricate vascular anatomy.
Implications:
- Complex coronary malformations may not always necessitate immediate treatment.
- Natural vascular pathways can potentially manage complex AVMs throughout a patient's lifetime.
- MDCT is a valuable tool for diagnosing and characterizing cardiac AVMs.
Abstract:
True cardiac arteriovenous malformations are rare anomalies that may be acquired or congenital in origin. These anomalies are well demonstrated by Multi Detector Computed Tomography (MDCT) with much higher clarity and anatomic detail than invasive angiography. We report a case of large complex cardiac vascular malformation in 55 year old male involving feeders from systemic (internal mammary artery, right inferior phrenic artery), coronary (left anterior descending), and pulmonary arterial and venous systems using a 64 slice MDCT scanner. Cardiac AV malformations have previously been described using MDCT, but this case is unique in terms of its large size, extensive involvement of systemic, coronary and pulmonary vascular connections, and mild clinical symptomatology. Our case shows that patients with complex coronary malformation may not always require treatment as natures' pathways may work well throughout lifetime.
