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Torres C, Gjergjindreaj M, Torres-Ortiz H, Fuentes J, Beohar N. Coronary Steal Syndrome Secondary to Large Coronary to Pulmonary Artery Fistulas. Cureus 2022; 14:e30267. [PMID: 36381934 PMCID: PMC9650949 DOI: 10.7759/cureus.30267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 06/16/2023] Open
Abstract
Coronary artery fistulas represent rare congenital or acquired defects in the coronary circulation. We describe a case of bilateral coronary to pulmonary artery fistulas resulting in coronary artery steal syndrome in a patient with a history of valve-sparing aortic repair surgery.
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Affiliation(s)
- Christian Torres
- Cardiology, Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, USA
| | - Medeona Gjergjindreaj
- Cardiology, Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, USA
| | - Hernando Torres-Ortiz
- Cardiology, Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, USA
| | - Jorge Fuentes
- Interventional Cardiology, Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, USA
| | - Nirat Beohar
- Interventional Cardiology, Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, USA
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Su S, Xia S, He Y, Li J, Ma L, Chen X, Li J. A Phenotype and Genotype Case Report of a Neonate With Congenital Bilateral Coronary Artery Fistulas and Multiple Collateral Arteries. Front Cardiovasc Med 2022; 9:939551. [PMID: 35872895 PMCID: PMC9299261 DOI: 10.3389/fcvm.2022.939551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
We report a unique case of an 18-day-old girl with three coronary artery fistulas to the right atrium and right ventricle, respectively: three collateral arteries arising from the descending aorta and one from the right subclavian artery draining through a sac to the top of the right atrium, patent ductus arteriosus, and atrial septal defect. She presented symptoms of acute congestive heart failure. Cardiac catheterization and surgical interventions were performed to repair the defects. The patient recovered uneventfully and grew up well at 3 years of follow-up. Whole-genome sequencing (WES) in the patient, compared to her parents, showed 17 variants within 11 genes. Among these, only compound heterozygous mutation, c.T470G (p.L157R) and c.A1622G (p.D541G), in the DRC1 gene have been reportedly related to congenital heart disease and are the most likely causative in our patient.
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Affiliation(s)
- Shixin Su
- Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Shuliang Xia
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Cardiovascular Surgery, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Ye He
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Department of Pediatric Surgery, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Jianbin Li
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Cardiac Intensive Care Unit, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Li Ma
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Cardiovascular Surgery, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
| | - Xinxin Chen
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Cardiovascular Surgery, Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- *Correspondence: Xinxin Chen
| | - Jia Li
- Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong, China
- Jia Li
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An X, Guo S, Dong H, Tang Y, Li L, Duan X, Ye S. Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature. BMC Cardiovasc Disord 2021; 21:273. [PMID: 34088261 PMCID: PMC8176730 DOI: 10.1186/s12872-021-02077-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/24/2021] [Indexed: 01/04/2023] Open
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.
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Affiliation(s)
- Xuanqi An
- State Key Laboratory of Cardiovascular Disease, Center of Internal Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Rd, Xicheng District, Beijing, 100037, People's Republic of China
| | - Shaoxian Guo
- State Key Laboratory of Cardiovascular Disease, Center of Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Huawei Dong
- State Key Laboratory of Cardiovascular Disease, Center of Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Yida Tang
- State Key Laboratory of Cardiovascular Disease, Center of Internal Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Rd, Xicheng District, Beijing, 100037, People's Republic of China
| | - Lin Li
- State Key Laboratory of Cardiovascular Disease, Center of Internal Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Rd, Xicheng District, Beijing, 100037, People's Republic of China
| | - Xuejing Duan
- State Key Laboratory of Cardiovascular Disease, Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China
| | - Shaodong Ye
- State Key Laboratory of Cardiovascular Disease, Center of Internal Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Rd, Xicheng District, Beijing, 100037, People's Republic of China.
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Chávez-Solsol, F, Murillo-Pérez L, Heredia-Oré R, Rodríguez-Urteaga Z, Toribio-Salazar M, Pérez-Valverde Y. [Cardiac Tamponade due to Rupture of a Giant Coronary Aneurysm over Coronary Fistulas: Report of an Unusual Case]. Arch Peru Cardiol Cir Cardiovasc 2020; 1:105-110. [PMID: 38572333 PMCID: PMC10986350 DOI: 10.47487/apcyccv.v1i2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/10/2020] [Indexed: 04/05/2024]
Abstract
Coronary artery fistulas are rare clinical entities and their association with giant coronary aneurysms is even more unusual. Most fistulas are asymptomatic, but aneurysms could develop symptoms depending on their diameter. We present a patient with chest pain and cardiac arrest, who later developed cardiac tamponade that needed emergency surgery, due to rupture of a giant coronary aneurysm developed from confluent coronary artery fistulas from two coronary arteries to pulmonary artery.
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Affiliation(s)
- Francisco Chávez-Solsol,
- Servicio de Cardiología Clínica. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú.Servicio de Cardiología ClínicaInstituto Nacional Cardiovascular - INCOR EsSaludLimaPerú
| | - Luis Murillo-Pérez
- Médico residente de Cardiología. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú.Instituto Nacional Cardiovascular - INCOR EsSaludLimaPerú
| | - Ricardo Heredia-Oré
- Médico residente de Cardiología. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú.Instituto Nacional Cardiovascular - INCOR EsSaludLimaPerú
| | - Zoila Rodríguez-Urteaga
- Servicio de Ayuda al Diagnóstico y Tratamiento. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú.Servicio de Ayuda al Diagnóstico y TratamientoInstituto Nacional Cardiovascular - INCOR EsSaludLimaPerú
| | - María Toribio-Salazar
- Médico residente de Cirugía de Tórax y Cardiovascular. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú.Instituto Nacional Cardiovascular - INCOR EsSaludLimaPerú
| | - Yemmy Pérez-Valverde
- Servicio de Cirugía Cardiovascular Adulto. Instituto Nacional Cardiovascular - INCOR EsSalud. Lima, Perú.Servicio de Cirugía Cardiovascular AdultoInstituto Nacional Cardiovascular - INCOR EsSaludLimaPerú
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