3D-Printed Visualization of a Complex Coronary-Venous Fistula With Additional Feeders From the Descending Aorta

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Interventional Cardiology

Background:

• Coronary-venous fistulas (CVFs) are rare anomalies that can present with diverse clinical symptoms.
• Accurate anatomical delineation is crucial for effective management of complex CVFs.

Purpose of the Study:

• To describe a case of a large, complex coronary-venous fistula with aortic feeders.
• To highlight the utility of multimodality imaging, including 3D printing, in characterizing such anomalies.

Main Methods:

• Computed tomography (CT) angiography was used for initial detection and characterization.
• Multicolor 3-dimensional (3D) printing was employed for detailed anatomical visualization.
• Conservative management was chosen for the patient.

Main Results:

• A large, complex CVF originating from the coronary arteries and receiving feeders from the descending aorta was identified.
• Multimodality imaging provided precise visualization of the fistula's origin, course, and drainage.
• The patient was successfully managed conservatively.

Conclusions:

• Complex CVFs, even with aortic feeders, can be precisely evaluated using advanced imaging techniques.
• Multimodality imaging, particularly 3D printing, offers significant value in understanding complex vascular anatomy.
• Conservative management can be a viable option for select cases of complex CVFs.