scholarly journals Surgical Repair of Congenital Coronary Artery Fistula With Giant Aneurysm

2020 ◽  
Vol 23 (2) ◽  
pp. E151-E153
Author(s):  
Xiaoyong Li ◽  
Laichun Song ◽  
Huiqiong Guo ◽  
Jing Jin ◽  
Ming Xu
Keyword(s):  
Coronary Artery ◽  
Giant Aneurysm ◽  
Coronary Aneurysm ◽  
Coronary Artery Fistula ◽  
Post Operation ◽  
History Of ◽  
Normal Blood Flow ◽  
Flow Through ◽  
Congenital Coronary Artery Fistula

A 67-year-old man with a 3-year history of dyspnea on exertion arrived to our institution with discontinuous palpitations and short breath. He was diagnosed with congenital coronary artery fistula (CAF). Angiography revealed 3 giant aneurysmal formations and coronary artery calcification. We report a case of successful repair of CAF with a giant coronary aneurysm by closing the orifice and resecting the aneurysm and reconstructing the left coronary artery. The surgical procedure included closure from within a vessel dilated by aneurysm and excision of the aneurysm. We were able to completely obliterate the fistula and preserve the normal blood flow through the coronary arteries post operation. The postoperative course was eventful, but the patient was discharged home. The patient was doing well at his 28-month follow-up visit.

scholarly journals A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair

2020 ◽  
Author(s):  
Giulia Poretti ◽  
Mauro Lo Rito ◽  
Alessandro Varrica ◽  
Alessandro Frigiola
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Giant Aneurysm ◽  
Coronary Aneurysm ◽  
Coronary Artery Fistula ◽  
Percutaneous Closure ◽  
Low Flow ◽  
Circumflex Artery ◽  
Coronary Aneurysms

Abstract Background Isolated coronary arteriovenous fistulas are extremely rare, accounting for 0.08–0.4% of all congenital heart disease. Closure of the fistula is recommended in cases of large dimensions, relevant left–right shunt, or ischaemic events. Thrombosis of the coronary aneurysms may occur as a postoperative complication. Case summary We report a case of a coronary fistula between the circumflex artery and coronary sinus with giant aneurysm. After a failed percutaneous closure attempt, the patient was surgically treated without major postoperative complications. Despite therapeutic anticoagulation and antiplatelet therapy, she presented at clinical follow-up with thrombosis of the dilated coronary artery without signs or symptoms of ischaemia. Discussion Management of coronary artery fistula may be challenging in cases in which initial percutaneous closure is unsuccessful. This particular case also highlights the importance of close follow-up, despite optimal therapy, to detect potentially lethal complications related to the low flow in the dilated coronary aneurysm.

Long-Term Follow-Up of Pediatric Patients After Congenital Coronary Artery Fistula Closure

2020 ◽  
Vol 41 (7) ◽  
pp. 1346-1353
Author(s):  
Xiaoyong Li ◽  
Laichun Song ◽  
Ming Xu ◽  
Gangcheng Zhang ◽  
Jing Jin
Keyword(s):  
Coronary Artery ◽  
Pediatric Patients ◽  
Coronary Artery Fistula ◽  
Fistula Closure ◽  
Long Term Follow Up ◽  
Congenital Coronary Artery Fistula

scholarly journals Congenital coronary artery fistula in pediatric patients: transcatheter versus surgical closure

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaoyong Wang ◽  
Chengcheng Pang ◽  
Xiaobing Liu ◽  
Shushui Wang ◽  
Zhiwei Zhang ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pediatric Patients ◽  
Group Versus ◽  
Final Analysis ◽  
Coronary Artery Fistula ◽  
Surgical Closure ◽  
Major Complications ◽  
Congenital Coronary Artery Fistula ◽  
The Mean

Abstract Objectives Transcatheter closure (TCC) and surgical closure (SC) are the two main approaches for congenital coronary artery fistula (CCAF), but data on the comparisons of the efficacy and safety of these two approaches are limited. Methods We retrospectively reviewed pediatric patients with CCAF in Guangdong Cardiovascular Institute between January 2002 and December 2017. Patients who were qualified into our criteria were included into final analysis. The rate of successful closure and complications during hospitalization and at follow-up were compared between SC and TCC groups. Results In total, 121 pediatric patients (male, n = 69; female, n = 52) with CCAF were divided to TCC (n = 63) and SC groups (n = 58) according to the indications. The mean age was 5.3 ± 1.4 years. The baseline characteristics of these two groups were similar except for the fistula anatomic feature. After adjusted for the fistula anatomy, compared to SC, TCC was associated with higher risk of major complications (p = 0.013). Proportions of patients requiring blood transfusion and intra-operative blood loss were higher in SC versus TCC groups, as were longer duration of hospital and ICU stay during hospitalization. In contrast, myocardial ischemia (10.2% vs 0.0%, p = 0.028), residual shunts (16.9% vs 3.6%, p = 0.045) and new-onset moderate-to-severe valve regurgitation (11.9% vs 0.0%, p = 0.013) were higher in TCC group versus SC groups during follow-up. Conclusions TCC has less invasive and faster recovery. However, SC had a higher successful rate and lower risk of major complications in pediatric patients.

Abstract 163: Regressed Coronary Aneurysm after Kawasaki Disease: What are they hiding? An Optical Coherence Tomography (OCT) study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Audrey Dionne ◽  
Anne Fournier ◽  
Ragui Ibrahim ◽  
Catherine Gebhard ◽  
Nagib Dahdah
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Intimal Hyperplasia ◽  
Imaging Techniques ◽  
Coronary Aneurysm ◽  
History Of ◽  
Oct Imaging ◽  
Coronary Events ◽  
Smooth Muscle Dysfunction

Background: Coronary artery aneurysms (CAA) are a serious complication of Kawasaki disease (KD). Regression of CAA occurs in 50% of the cases on follow up. Actual imaging techniques often described these segments as normal, whereas studies have shown significant endothelial and smooth muscle dysfunction. Method: KD patients scheduled for angiographic follow-up between June 2013 and August 2014 underwent OCT imaging. We compared coronary intimal changes in coronary artery segments with no history of CAA to segments with regressed CAA, and segments with persistent CAA. The intima was measured in sections adjacent to the CAA for the segments with persistent CAA, at the former CAA and adjacent sections for those who regressed, and at various corresponding sections for segments with no history of CAA. Results: OCT was performed on 18 patients at 12.4 ± 5.5 years. Overall 14/18 (77.7%) had a history of CAA. Of those, 7/14 (50.0%) had regressed CAA at time of OCT. Data was analyzed according to echocardiographic and angiographic progress of CAA segments. Accordingly, all 18/18 persistent CAA segments and 11/11 regressed CAA segments had significant intimal hyperplasia, compared to 1/13 with no history of segmental CAA (P<0.001). The intensity of intimal hyperplasia is displayed in Table 1. Conclusion: Despite normal angiographic features, regressed CAA segments displayed significant intimal hyperplasia, similarly to those with persistent CAA. These features may present a risk of adverse coronary events.

scholarly journals Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xuanqi An ◽  
Shaoxian Guo ◽  
Huawei Dong ◽  
Yida Tang ◽  
Lin Li ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Thrombus Formation ◽  
Coronary Aneurysm ◽  
Aneurysmal Dilatation ◽  
Aneurysmal Dilation ◽  
History Of ◽  
Aneurysm Thrombosis ◽  
Pulmonary Artery Fistula

Abstract Background Coronary artery-to-pulmonary artery fistula is a rare disorder characterized by abnormal vascular communication between the coronary artery and pulmonary artery. While most patients remain asymptomatic, some might exhibit symptoms of myocardial ischemia, congestive heart failure, or even sudden cardiac death if coronary aneurysm, thrombosis, infective carditis, or other congenital cardiac defects coexist. Case presentation We present a 66-year-old male complaining of angina pectoris with a history of hypertension and active smoking. He was diagnosed with a coronary aneurysm based on coronary computed tomography angiography. We subsequently identified a coronary artery-to-pulmonary artery fistula with giant aneurysmal dilation on coronary angiography. Ultimately we conducted surgery ligation and aneurysmorrhaphy. During surgery, we discovered newly formed thrombus within the aneurysmal cavity. Histological analysis of the aneurysmal wall supported the diagnosis of the congenital disorder. Our patient was successfully discharged and remained asymptomatic at two months of follow-up. Conclusion We presented a rare and complex combination of congenital coronary artery-to pulmonary artery fistula, giant coronary aneurysmal dilatation, and thrombosis through multi-modality evaluations.

Congenital Left Main Coronary Artery to Coronary Sinus Fistula

2011 ◽  
Vol 14 (4) ◽  
pp. 255 ◽  
Author(s):  
Fotios A. Mitropoulos ◽  
Meletios A. Kanakis ◽  
Periklis A. Davlouros ◽  
George Triantis
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Sinus ◽  
Left Main Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Main ◽  
Coronary Fistula ◽  
Excellent Outcome ◽  
Surgical Ligation ◽  
Congenital Coronary Artery Fistula

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.

Giant right coronary artery aneurysm

2020 ◽  
Vol 28 ◽  
pp. 1-3
Author(s):  
Alexandre Bonfim ◽  
Ronald Souza ◽  
Sérgio Beraldo ◽  
Frederico Nunes ◽  
Daniel Beraldo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Clinical Course ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Artery Aneurysms ◽  
History Of ◽  
Artery Disease ◽  
The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

scholarly journals Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan
Keyword(s):  
Doppler Ultrasound ◽  
Renal Allograft ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Imaging Findings ◽  
Unenhanced Ct ◽  
Doppler Signals ◽  
History Of ◽  
Normal Blood Flow

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

scholarly journals Mid- to long-term follow-up of pediatric patients with coronary artery fistula

2016 ◽  
Vol 115 (7) ◽  
pp. 571-576 ◽  
Author(s):  
Mao-Hung Lo ◽  
I-Chun Lin ◽  
Kai-Sheng Hsieh ◽  
Chien-Fu Huang ◽  
Shao-Ju Chien ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pediatric Patients ◽  
Coronary Artery Fistula ◽  
Long Term Follow Up
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