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Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Coronary arteriovenous fistula: surgical correction of a rare form
E P Bauer1, A Piepho, W P Klövekorn
1Max-Planck-Institute for Clinical and Physiological Research, Kerckhoff-Clinic, Bad Nauheim, Germany.
Insights
Coronary arteriovenous fistulae were successfully treated using surgical ligation and a transcoronary approach. These techniques prevent heart attack and recurrence of the condition.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Coronary arteriovenous fistulae (CAVF) are rare congenital or acquired abnormalities.
- Long-standing angina can be a symptom of undiagnosed CAVF.
Observation:
- A 60-year-old woman presented with long-standing angina.
- Left heart catheterization revealed peripheral and central coronary arteriovenous fistulae connecting to both coronary systems and draining into the pulmonary artery.
Findings:
- Peripheral fistulae involving terminal coronary artery branches were treated with surgical ligation under continuous electrocardiogram monitoring.
- Central fistulae were successfully closed using a transcoronary approach via the left anterior descending artery.
Implications:
- Knowledge of diverse surgical techniques is crucial for managing coronary arteriovenous fistulae.
- Appropriate surgical intervention can prevent perioperative myocardial infarction and late fistula recurrence.
Abstract:
In a 60-year-old woman with long-standing angina left heart catheterisation revealed peripheral and central coronary arteriovenous fistulae connected to the left and right coronary system and opening into the pulmonary artery. The fistulae connected to terminal coronary artery branches were corrected by ligation of these feeding arteries while the electrocardiogram was continuously monitored. The central fistulae were closed via a transcoronary approach of the left anterior descending artery. Knowledge of different surgical techniques helps to prevent perioperative myocardial infarction and late fistula recurrence.
