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Ebik M, Öztürk C, Ustabaşıoğlu FE. Double Coronary-Cameral Fistula Draining to the Right Ventricle in a Patient with Mitral Stenosis: is it Clinically Relevant? Balkan Med J 2023; 40:449-450. [PMID: 37727045 PMCID: PMC10613751 DOI: 10.4274/balkanmedj.galenos.2023.2023-7-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023] Open
Affiliation(s)
- Mustafa Ebik
- Clinic of Cardiology, Edirne Sultan 1. Murat State Hospital, Edirne, Türkiye
| | - Cihan Öztürk
- Department of Cardiology, Trakya University Faculty of Medicine, Edirne, Türkiye
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Ashraf M, Jaglan A, Jan MF, Jahangir A, Sanders H, Schweitzer M, Tajik AJ. Post-Septal Myectomy Coronary-Cameral Fistula: A Brief Review and Search for Underlying Mechanisms. J Am Soc Echocardiogr 2023; 36:1008-1009. [PMID: 37367705 DOI: 10.1016/j.echo.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Muddasir Ashraf
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
| | - Akshar Jaglan
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
| | - M Fuad Jan
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
| | - Arshad Jahangir
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
| | - Heather Sanders
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
| | - McKenzie Schweitzer
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
| | - A Jamil Tajik
- Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin
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Bowden S, Winter RL, Hostnik ET, Habing A, Green E. Right coronary artery to left ventricle coronary cameral fistula in a cat. J Vet Cardiol 2022; 44:57-62. [PMID: 36375402 DOI: 10.1016/j.jvc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/12/2022]
Abstract
A six-month-old female intact domestic shorthair cat was presented for evaluation of a loud heart murmur. Transthoracic echocardiography revealed dilation of the left ventricle secondary to an abnormal vessel shunting blood into the left ventricular outflow tract at a high velocity during diastole. Multidetector computed tomography angiography revealed a coronary cameral fistula that originated at the right coronary artery, encircled the heart, and then terminated into the left ventricular outflow tract. This case report documents the first known case of a coronary cameral fistula in a cat. Multimodal imaging was an essential aspect to diagnosing the congenital lesion in this case.
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Affiliation(s)
- S Bowden
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, 601 Vernon L. Tharp St, Columbus, OH 43210, USA
| | - R L Winter
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL, 36832, USA.
| | - E T Hostnik
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, 601 Vernon L. Tharp St, Columbus, OH 43210, USA
| | - A Habing
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, 601 Vernon L. Tharp St, Columbus, OH 43210, USA
| | - E Green
- Department of Clinical Sciences, College of Veterinary Medicine, Ohio State University, 601 Vernon L. Tharp St, Columbus, OH 43210, USA
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Mokkarala M, Ballard DH, Wesley RA, Gutierrez FR, Javidan-Nejad C, Singh GK, Woodard PK, Lindley KJ. Coronary-cameral fistula with double-chambered right ventricle: appearance on cardiac magnetic resonance imaging and 3D printed anatomic modeling. Clin Imaging 2019; 59:84-87. [PMID: 31760282 DOI: 10.1016/j.clinimag.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/17/2019] [Accepted: 10/31/2019] [Indexed: 12/16/2022]
Abstract
The present case illustrates cardiac magnetic resonance imaging (MRI) and three-dimensional (3D) printed anatomic model findings of a coronary-cameral fistula (CCF) and double-chambered right ventricle (DCRV). A pregnant woman presented with palpitations and near syncope. A non-contrast cardiac MRI showed CCF connecting to a DCRV. Post-delivery, the patient had a contrast-enhanced MRI and 3D printed anatomic model to better evaluate her aberrant anatomy.
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Affiliation(s)
- Mahati Mokkarala
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Robert A Wesley
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Fernando R Gutierrez
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Cylen Javidan-Nejad
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Gautam K Singh
- Department of Pediatrics, Washington University School of Medicine, Saint Louis Children's Hospital, St. Louis, MO, United States of America
| | - Pamela K Woodard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Kathryn J Lindley
- Cardiovascular Division, Internal Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
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Affiliation(s)
- A Seeraj
- Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago
| | - S Roop
- Eric Williams Medical Sciences Complex, Uriah Butler Highway, Champ Fleurs, Trinidad and Tobago
| | - F Rampersad
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Building 67, 2nd Floor, Eric Williams Medical Sciences Complex, Trinidad and Tobago
| | - R G Ali
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Building 67, 2nd Floor, Eric Williams Medical Sciences Complex, Trinidad and Tobago
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Iyer P, Yelisetti R. Multiple left anterior descending coronary artery to left ventricular fistula - A case series and literature review. J Community Hosp Intern Med Perspect 2017; 7:258-261. [PMID: 29046757 PMCID: PMC5637639 DOI: 10.1080/20009666.2017.1369380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/10/2017] [Indexed: 11/23/2022] Open
Abstract
Coronary artery fistulas (CAFs) are found in 0.3–0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle. In both the cases, No intervention was performed. Of the congenital fistulas, two major groups are identified: solitary CAFs or coronary artery-left ventricular multiple micro-fistulas (CALVMMFs). Noninvasive techniques such as transthoracic echocardiography, transesophageal echocardiography and magnetic resonance imaging are becoming increasingly popular for diagnosis and follow-up of CAFs. Despite the advent of these newer non-invasive modalities, coronary angiography remains the gold standard for diagnosis. Treatment of CAFs is indicated when the patients are symptomatic with left ventricular volume overload, myocardial ischemia, left ventricular dysfunction or in the presence of a large or increasing left-to-right shunt. If the fistula is small and hemodynamically insignificant, it can be managed with conservative management. Multiple left anterior descending to left ventricle (LV) fistulas are extremely rare and, as per our literature review, we noted only a few case reports of coronary artery fistulas between branches of LAD and left ventricle.
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Affiliation(s)
- Praneet Iyer
- Department of Pulmonary and Critical Care, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Rishitha Yelisetti
- Department of Internal Medicine, Seton Hall University of Health and Medical Science at St Francis Medical Center, Trenton, NJ, USA
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Firuzi A, Alemzadeh-Ansari MJ, Pouraliakbar HR. Transcatheter coil embolization of iatrogenic coronary artery-left ventricle fistula after mitral valve replacement. J Saudi Heart Assoc 2017; 29:148-152. [PMID: 28373791 PMCID: PMC5366659 DOI: 10.1016/j.jsha.2016.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/25/2016] [Accepted: 10/31/2016] [Indexed: 11/02/2022] Open
Abstract
Acquired causes of coronary fistulas are rare disorders and may develop following coronary atherosclerosis, infection, or trauma (iatrogenic). Iatrogenic coronary fistulas may be acquired secondary to surgical or nonsurgical interventions. We describe a case of an iatrogenic coronary artery-left ventricle fistula following mitral valve replacement surgery, presented with ventricular arrhythmia and heart failure. In a unique technique, we implanted three coils with the aid of a Scepter C balloon with inflation at the ostial portion of the left circumflex artery.
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Affiliation(s)
- Ata Firuzi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, aIran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, aIran
| | - Hamid Reza Pouraliakbar
- Radiology Department, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, bIran
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Cerit L, Gulsen K, Kemal H, Akpınar O. A case of coronary microfistula: A newborn microfistula. Indian Heart J 2016; 68:192-3. [DOI: 10.1016/j.ihj.2015.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022] Open
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Coronary cameral fistula in an asymptomatic young female presenting with dynamic ST-T changes. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2016. [DOI: 10.1016/j.injms.2015.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Detorakis EE, Foukarakis E, Karavolias G, Dermitzakis A. Cardiovascular magnetic resonance and computed tomography in the evaluation of aneurysmal coronary-cameral fistula. J Radiol Case Rep 2015; 9:10-21. [PMID: 26629294 PMCID: PMC4638407 DOI: 10.3941/jrcr.v9i7.2305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Coronary artery fistulas represent abnormal communications between a coronary artery and a major vessel like venae cavae, pulmonary arteries or veins, the coronary sinus, or a cardiac chamber. The latter is called coronary cameral fistula is a rare condition and is most of the times congenital but can be also post traumatic or post surgical, especially after cardiovascular interventional procedures. Most patients are asymptomatic and coronary-cameral fistulae are discovered incidentally during angiographic evaluation for coronary vascular disorders, while other patients have a clinical presentation ranging from angina pectoris to heart failure. In this article, we report a rare case of an aneurysmal right coronary cameral fistula draining into the left ventricle. Echocardiography usually represents the first diagnostic imaging approach, but often due to a poor acoustic window may not show the entire course of the fistula which is crucial for the final diagnosis. ECG-gated cardiovascular CT may play an important role in the evaluation of the origin, course, termination and morphology of the fistula, its relation to the adjacent anatomical structures as well as the morphology and contractility of the heart. Cardiac MRI instead plays an additional crucial role regarding not only the above mentioned factors but also in estimating the blood flow within the fistula, providing more detailed information about the cardiac function but also about myocardial wall viability.
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Affiliation(s)
- Efstathios E Detorakis
- Department of Radiology, CT and MRI unit, Euromedic International, Heraklion, Crete, Greece
| | - Emmanouil Foukarakis
- Department of Cardiology, General Hospital of Heraklion"Venizeleio - Pananeio", Heraklion, Crete, Greece
| | - George Karavolias
- Second department of interventional cardiology, Onassis cardiac surgery centre, Athens, Greece
| | - Alkiviades Dermitzakis
- Department of Cardiology, General Hospital of Heraklion"Venizeleio - Pananeio", Heraklion, Crete, Greece
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Said SAM, Bloo R, Nooijer RD, Slootweg A. Cardiac and non-cardiac causes of T-wave inversion in the precordial leads in adult subjects: A Dutch case series and review of the literature. World J Cardiol 2015; 7:86-100. [PMID: 25717356 PMCID: PMC4325305 DOI: 10.4330/wjc.v7.i2.86] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/14/2014] [Accepted: 01/12/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To describe the electrocardiographic (ECG) phenomena characterized by T-wave inversion in the precordial leads in adults and to highlight its differential diagnosis.
METHODS: A retrospective chart review of 8 adult patients who were admitted with ECG T-wave inversion in the anterior chest leads with or without prolongation of corrected QT (QTc) interval. They had different clinical conditions. Each patient underwent appropriate clinical assessment including investigation for myocardial involvement. Single and multimodality non-invasive, semi-invasive and invasive diagnostic approach were used to ascertain the diagnosis. The diagnostic assessment included biochemical investigation, cardiac and abdominal ultrasound, cerebral and chest computed tomography, nuclear medicine and coronary angiography.
RESULTS: Eight adult subjects (5 females) with a mean age of 66 years (range 51 to 82) are analyzed. The etiology of T-wave inversion in the precordial leads were diverse. On admission, all patients had normal blood pressure and the ECG showed sinus rhythm. Five patients showed marked prolongation of the QTc interval. The longest QTc interval (639 ms) was found in the patient with pheochromocytoma. Giant T-wave inversion (≥ 10 mm) was found in pheochromocytoma followed by electroconvulsive therapy and finally ischemic heart disease. The deepest T-wave was measured in lead V3 (5 ×). In 3 patients presented with mild T-wave inversion (patients 1, 5 and 4 mm), the QTc interval was not prolonged (432, 409 and 424 msec), respectively.
CONCLUSION: T-wave inversion associated with or without QTc prolongation requires meticulous history taking, physical examination and tailored diagnostic modalities to reach rapid and correct diagnosis to establish appropriate therapeutic intervention.
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Manoly I, Mahadevan VS, Hoschtitzky JA. Hybrid Approach to Closure of an Acquired Coronary-Cameral Fistula. Ann Thorac Surg 2014; 98:e59-61. [DOI: 10.1016/j.athoracsur.2014.05.094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 05/14/2014] [Accepted: 05/27/2014] [Indexed: 10/24/2022]
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Yuksel S, Yasar E, Nar G, Gulel O, Demircan S, Yilmaz O, Sahin M. Prevalence and characteristics of coronary-cameral communications in adult patients: coronary angiographic analysis of 16,573 patients. Med Princ Pract 2014; 23:336-9. [PMID: 24924735 PMCID: PMC5586900 DOI: 10.1159/000363183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 04/27/2014] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To analyze the coronary angiograms of patients with symptomatic heart disease in order to determine the frequency and characteristics of coronary-cameral communications (CCCs) in a single center. SUBJECTS AND METHODS The coronary angiograms of 16,573 patients with symptomatic heart disease performed from November 2001 to January 2011 were analyzed. The diagnosis of coronary fistula and coronary-cameral microcommunications (CCMCs) was made according to previously defined criteria. RESULTS Of the 16,573 patients, 15 (0.09%; 8 males and 7 females, mean age 63 ± 12 years) had CCCs, while coronary fistulas were identified in 2 (0.01%). In the first patient, the coronary fistula arose from the branches of the left anterior descending (LAD) artery and the right coronary artery (RCA) and drained into the right ventricle. In the second patient, the fistula originated from branches of the LAD artery, the circumflex (Cx) artery and the RCA and drained into the left ventricle. In 7 patients, the CCMCs originated from the LAD artery. In 3 patients, the Cx artery was the origin. The CCMCs originated from the RCA in 2 patients. In 1 patient the CCMC took its origin from the RCA and the Cx artery, while in 2 patients the CCMCs were associated with intracardiac masses in the left atrium and the right atrium, respectively. CONCLUSION The prevalence of CCCs in adult patients was low and that of large coronary fistulas was even lower; coronary fistulas are probably very rare in adult patients because the majority of them are detected and treated during childhood.
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Affiliation(s)
- Serkan Yuksel
- *Serkan Yüksel, Department of Cardiology, Faculty of Medicine, Ondokuz Mayýs University, TR-55139 Samsun (Turkey), E-Mail
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