Coronary Artery Fistula From the Left Circumflex to Coronary Sinus
Diego Silva-Mendoza1, Atul Eppurath2, Ramy Shoela2
1Saint Louis University School of Medicine, St Louis, Missouri, USA.
Insights
Coronary arteriovenous fistulas (CAVFs) are rare, especially between the left circumflex artery and coronary sinus. Discrepancies in diagnostic imaging can complicate treatment planning for these complex vascular anomalies.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Coronary arteriovenous fistulas (CAVFs) are uncommon, affecting 0.1%–0.9% of patients undergoing coronary angiography.
- Fistulas involving the left circumflex artery and coronary sinus are particularly rare.
Background:
Coronary arteriovenous fistulas (CAVFs) are rare occurrences with an incidence of 0.1% to 0.9% on coronary angiography. Fistulas between the left circumflex coronary artery and coronary sinus are even less common.
Case Summary:
A 71-year-old female underwent extensive diagnostic imaging for CAVF. Intervention with catheterized closure and coil embolization was planned but not performed due to disparate anatomy of the CAVF on echocardiogram, magnetic resonance imaging, computed tomography, and coronary angiography. Because of these discrepancies, there was an uncertain risk for distal embolization of the coils.
Discussion:
Variance in diagnostic interpretation from different imaging modalities can lead to difficulty in confirming the anatomy of a CAVF and hinder resolution. Best-practice diagnostic imaging and treatment options for CAVFs are discussed.
Take-Home Messages:
Fistulas between the LCX and CS are rare, and their characteristics, origin, and termination can be difficult to determine without appropriate imaging modalities. This case highlights the efficacy of different imaging and treatment options for CAVFs.
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