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Transcatheter embolization of a coronary arteriovenous fistula with a complex, helical-fibered platinum coil
1Department of Cardiology, Taipei Municipal Chung Hsiao Hospital, Taiwan, ROC.
Insights
Transcatheter embolization effectively treated a coronary arteriovenous fistula in a 51-year-old man. The procedure provided complete symptom relief from angina pectoris, demonstrating a successful minimally invasive treatment for this rare condition.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary arteriovenous fistulas (CAVF) are rare congenital or acquired abnormalities.
- Symptoms like angina pectoris can develop due to altered coronary hemodynamics.
- Treatment options range from conservative management to surgical or interventional closure.
Observation:
- A 51-year-old male presented with a history of angina pectoris since childhood, worsening over the last 5 years.
- Diagnostic workup revealed a coronary arteriovenous fistula originating from the left circumflex artery and draining into the superior vena cava.
- The patient's symptoms were attributed to the hemodynamic consequences of the fistula.
Findings:
- Transcatheter embolization was successfully performed using a 2 x 20 mm helical-fibered platinum coil.
- The coil was deployed in the mid-portion of the fistula, achieving complete occlusion.
- The procedure was completed within 30 minutes.
Implications:
- Transcatheter embolization offers a minimally invasive and effective treatment for coronary arteriovenous fistulas.
- Successful fistula occlusion led to complete resolution of angina pectoris symptoms.
- This approach provides a valuable alternative to surgical intervention for selected patients with CAVF.
Abstract:
Transcatheter embolization was successfully performed on a 51-year-old man with a coronary arteriovenous fistula arising from the left circumflex coronary artery and draining into the superior vena cava. The patient presented with typical manifestations of angina pectoris that were first noticed during childhood but had worsened over the past 5 years. A 2 x 20 mm complex, helical-fibered platinum coil was placed in the mid-portion of the fistula and successfully occluded the fistula within 30 minutes. The patient has been free from angina pectoris since the procedure.