A case report of superior vena cava/right coronary artery fistula secondary to chronic endocarditis

Area of Science:

• Cardiology
• Vascular Surgery

Background:

• Coronary arteriovenous fistulas (CAVF) are uncommon abnormal connections between coronary arteries and adjacent vessels, affecting 0.002% of the population.
• While most CAVFs are congenital, they can also result from trauma or cardiac procedures.

Observation:

• A 48-year-old male with a history of untreated bacterial endocarditis developed a fistula between the right coronary artery and the superior vena cava.
• Imaging revealed this rare coronary arteriovenous fistula, detailing its anatomical characteristics.

Findings:

• This case represents the first documented instance of a right coronary artery to superior vena cava fistula caused by chronic, untreated bacterial endocarditis.
• The patient's clinical course and potential interventions, including surgical options, were considered.

Implications:

• This case underscores the importance of recognizing rare complications of endocarditis.
• Clinicians should maintain awareness of coronary arteriovenous fistulas as a potential sequela of untreated bacterial endocarditis.