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Multimodality Imaging of Giant Coronary Aneurysm and Spontaneous Thrombosis With Left Coronary Artery-Right Atrium
Minjie Wan1, Wei He1, Min Ye1
1Department of Medical Ultrasonics, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Insights
Coronary artery fistulas (CAF) are rare vascular malformations. Surgical intervention is recommended for patients with CAF exhibiting high-risk factors like aneurysm rupture or atrial fibrillation.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Diagnostics
Background:
- Coronary artery fistulas (CAF) are uncommon congenital or acquired abnormalities.
- Most CAF drain into the right atrium or pulmonary artery, with the right coronary artery being the most frequent origin.
- CAF often remain asymptomatic and are discovered incidentally.
Abstract:
Coronary artery fistulas (CAF) are rare and can be subdivided into coronary-cameral fistulas and coronary arteriovenous fistulas. The majority of these fistulae drain into the right atrium or the pulmonary artery. The right coronary artery (RCA) is the most common site for CAF, accounting for approximately 55% of cases, followed by the left coronary artery(LCA ) (35%). Usually, CAF are discovered accidentally for no unique features and symptoms. However, symptoms such as myocardial ischemia, heart failure, and arrhythmias may appear when the patient has a large shunt volume. Given the presence of high-risk factors such as aneurysm rupture, thrombosis, and atrial fibrillation (AF), surgical intervention was performed on this patient.
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