Case presentation: successful occlusion of congenital left ventricle to coronary sinus fistula
Hojjat Mortezaeian1, Avisa Tabib1, Hamidreza Pouraliakbar1
1Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
This case report details a rare congenital left ventricle to coronary sinus fistula diagnosed in an 18-month-old boy. Successful transcatheter occlusion was achieved, with no complications at one-year follow-up.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Congenital left ventricle to coronary sinus fistulas are exceptionally rare cardiac malformations.
- These fistulas can be isolated or associated with other congenital heart defects (CHDs).
Purpose of the Study:
- To report a case of congenital left ventricle to coronary sinus fistula in an infant.
- To highlight diagnostic methods and successful transcatheter management of this rare condition.
Main Methods:
- Echocardiography was used for initial diagnosis and assessment.
- CT angiography corroborated the echocardiographic findings.
- Transcatheter occlusion was performed to close the fistula.
Main Results:
- An 18-month-old boy was diagnosed with a left ventricle to coronary sinus fistula, not mitral regurgitation or ASD as initially suspected.
- Echocardiography revealed fistula and coronary sinus dilation, confirmed by CT angiography.
- Successful transcatheter occlusion of the fistula was achieved.
Conclusions:
- Congenital left ventricle to coronary sinus fistula is a rare diagnosis that can be accurately identified with echocardiography.
- Transcatheter intervention is a safe and effective treatment for this condition.
- One-year follow-up demonstrated no complications and no significant shunting post-procedure.
Abstract:
Congenital left ventricle to coronary sinus fistulas are exceptionally rare, and only a few case reports of this condition exist. These fistulas may isolated or occur in conjunction with other CHDs. In this case report, we describe an 18-month-old boy who presented to our centre with a diagnosis of mitral valve insufficiency and a coronary sinus-type atrial septal defect. Upon echocardiographic evaluation, he was found to have a rare congenital left ventricle to coronary sinus fistula. Echocardiographic examination established the diagnosis. Contrary to initial suspicions, mitral regurgitation and atrial septal defect were not present. Instead, the echocardiogram revealed a left ventricular to coronary sinus fistula accompanied by dilation of the coronary sinus. These findings were corroborated by CT angiography. The fistula was then successfully occluded using a transcatheter method. Follow-up assessments at one-year post-procedure showed no complications and no evidence of significant shunting on echocardiography.
