Coronary arteriovenous fistula draining into single left superior vena cava

Area of Science:

• Cardiology
• Congenital Heart Disease
• Vascular Surgery

Background:

• Persistent left superior vena cava (LSVC) without a right superior vena cava (RSVC) is a rare congenital anomaly.
• Coronary arteriovenous fistulas (CAVF) can occur as a complication of vascular anomalies.
• This case presents a unique combination of LSVC and CAVF leading to heart failure.

Purpose of the Study:

• To report a rare case of persistent LSVC with a coronary arteriovenous fistula causing heart failure.
• To describe the surgical management and successful outcome of this rare anomaly.

Main Methods:

• Diagnostic evaluation including imaging to identify the anomaly.
• Surgical intervention using cardiopulmonary bypass.
• Closure of the coronary arteriovenous fistula using a pericardial patch.

Main Results:

• Successful identification and surgical closure of the coronary arteriovenous fistula.
• Resolution of heart failure symptoms post-operatively.
• The patient had a persistent LSVC and absence of RSVC.

Conclusions:

• Surgical repair of coronary arteriovenous fistula in the context of a single superior vena cava is feasible and effective.
• This case highlights the importance of recognizing and managing rare congenital cardiovascular anomalies.
• Early diagnosis and intervention can lead to favorable outcomes in patients with complex congenital heart defects.