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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Percutaneous management strategies for STEMI with coexisting aneurysmal coronary- to-pulmonary artery fistula: a case

Jennifer Frampton1, Eric Rothstein1, Alexander Iribarne2

  • 1Section of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA.

European Heart Journal. Case Reports
|June 14, 2021
PubMed

Insights

This case report details a rare instance of coronary artery fistula coexisting with coronary artery disease (CAD). A percutaneous approach successfully treated both the myocardial infarction and the fistula.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary artery fistulas (CAFs) are uncommon vascular anomalies.
  • The coexistence of CAFs and atherosclerotic coronary artery disease (CAD) is exceptionally rare.

Observation:

  • A patient presented with an anterior ST-elevation myocardial infarction.
  • Diagnostic imaging revealed two-vessel CAD and an aneurysmal left coronary-to-right pulmonary artery fistula.

Findings:

  • A multidisciplinary heart team decided on a percutaneous approach.
  • Successful treatment involved multivessel percutaneous coronary intervention and subsequent fistula embolization.

Implications:

  • This case highlights a successful combined percutaneous strategy for managing complex coronary artery disease and congenital coronary artery fistulas.
  • Percutaneous intervention offers a viable treatment option for this rare clinical scenario.
Abstract

Keywords:
Case reportCoronary artery fistulaFistula embolizationSTEMI

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