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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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Surgical Management of a Right Coronary Artery Fistula After Failed Transcatheter Closure: A Case Report

Alassal Ahmed1, Lamia A Alkodami2, Mustafa A AlMuhaya1

  • 1Cardiac Surgery, Madina Cardiac Center, Madina, SAU.

Cureus
|April 10, 2025
PubMed

Insights

Coronary artery fistulas (CAFs) are rare abnormal vessel connections. This case highlights surgical closure for a symptomatic right coronary artery-coronary sinus fistula to prevent serious cardiac events.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Coronary artery fistulas (CAFs) represent rare abnormal connections between coronary arteries and great vessels or cardiac chambers.
  • While often congenital and asymptomatic, CAFs can be acquired and lead to significant complications if large or symptomatic.

Observation:

  • A 52-year-old male presented with a right coronary artery-coronary sinus fistula.
  • Symptoms such as angina pectoris can arise from the coronary steal phenomenon in moderate to large CAFs.

Findings:

  • The patient's right coronary artery-coronary sinus fistula was successfully managed with surgical closure.
  • Prompt intervention is crucial for symptomatic CAFs to mitigate risks.

Implications:

  • Surgical intervention remains a viable option for managing complex coronary artery fistulas.
  • Effective management of CAFs is essential to prevent myocardial infarction, heart failure, and sudden cardiac death.

Keywords:
congenital anomalies of coronary arteriescongenital coronary anomalycongenital coronary artery anomalycoronary arterial fistulacoronary cameral fistularight coronary artery (rca)

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