Monster left circumflex artery fistula closure by vascular plug in a patient with post-COVID-19 myocardial infarction
Peyman Izadpanah1, Zahra Hooshanginezhad2, Mohammad Shojaie2
1Department of Cardiology Shiraz University of Medical Sciences Shiraz Iran.
Insights
A large coronary artery fistula was successfully closed using a vascular plug, resolving heart failure symptoms. This transcatheter method offers an alternative for high-risk patients needing closure of coronary fistulas.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery fistulas are abnormal connections between a coronary artery and a heart chamber or vessel.
- Large, high-flow fistulas can lead to heart failure and other complications.
Observation:
- A patient presented with a massive coronary artery fistula originating from the left circumflex artery and draining into the right ventricle.
- The patient developed progressive heart failure refractory to medical management.
Findings:
- Successful endovascular closure of the coronary fistula was achieved using a vascular plug.
- Transcatheter vascular plug occlusion is a viable alternative for managing symptomatic, large coronary artery fistulas.
Implications:
- This approach provides a less invasive treatment option for patients with coronary fistulas who are poor surgical candidates.
- Vascular plug occlusion may reduce risks associated with traditional coil embolization, such as dislocation or embolization.
- Further research may explore the long-term efficacy and safety of vascular plug closure for coronary fistulas.
Abstract:
Herein, we report a man with a huge coronary fistula connecting the left circumflex coronary artery to the right ventricle. During the follow-up, the patient developed progressive symptoms of heart failure nonresponsive to medical treatment. Therefore, an endovascular closure with a vascular plug was successfully done for him. Transcatheter vascular plug occlusion can be considered as an alternative for closure of symptomatic high-flow large coronary artery fistulas in patients with a high risk of surgery and chance of coil dislocation, embolization, or unavailability of proper coils.
