We describe an unusual case of left ventricle-left coronary artery-pulmonary artery fistula associated with hypoplastic left heart syndrome (HLHS) and a ventricular septal defect, in which findings on echocardiography and histological analysis were correlated. The diagnosis was made at 22 weeks of gestation. We speculated that the presence of the ...

A 56-year-old man developed left heart failure secondary to left to right shunt due to acquired aorto-pulmonary artery (PA) fistula. He had previously undergone aortic root replacement for streptococcal aortic valve endocarditis. A modified strategy involving interventional radiology and surgical technique was employed to deal with this complex surgical challenge. ...

A 14-year-old boy presented with spontaneous, painless proptosis of the right eye. Computed tomography and digital subtraction angiography revealed an indirect carotid cavernous fistula. Because there were no sight-threatening complications, we adopted a conservative approach. The condition resolved 1 month after initial presentation, with angiographically confirmed spontaneous obliteration of the ...

Tracheo-innominate artery fistula (TIF) is known as a fatal complication after tracheostomy. We report a 9-year-old girl with early hypoxic encephalopathy who had a tracheo-innominate artery fistula with exsanguinating hemorrhage from her tracheostoma 10 months after tracheostomy. After temporary control of bleeding, embolization of the innominate artery was performed. The ...

An H-type fistula represents the isolated form of tracheoesophageal fistula, and it is relatively uncommon. Conventional thoracotomy is associated with significant late sequelae; scapula alata, scoliosis, and excessive scarring [Konkin DE, O'hali WA, Webber EM, Blair GK. Outcomes in esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 2003;38:1726-9]. Thoracoscopic approaches ...

A 69-year-old man who had a left pneumonectomy for nonsmall cell lung cancer had a bronchopulmonary fistula develop that recurred after surgical closure. He had multiple organ failure develop precluding further operative intervention. Successful resolution of the fistula was achieved using a novel application of a covered expandable metallic stent.

Precise localization of the fistula is the most important step in the operative strategy for dealing with H-type tracheoesophageal fistula. Bronchoscopic cannulation of the fistula with a Fogarty or ureteric catheter has been recommended to aid ready identification, but it is not always successful. We report an innovative technique that ...

Off-pump surgery was performed in a patient with post-infarction angina complicated with aneurysmal coronary-pulmonary arterial fistula. Epicardial echocardiography localized the artery feeding the fistula in the myocardium, which had not been revealed by visual inspection, palpation, or transesophageal echocardiography. The patient underwent off-pump coronary artery bypass grafting concomitant with aneurysmectomy. ...

A congenital chest wall systemic-to-left pulmonary artery fistula fed by the left internal mammary and left gastric arteries in a 31-year-old man is reported. Attempted sclerosis was complicated by rupture of the communicating vessel, hemothorax, and deep vein thrombosis of the legs. Fistula resection and pulmonary decortication were successfully performed.

Leakage and fistula are feared complications after gastro-intestinal anastomosis. A 36-year-old female underwent an one-anastomosis gastric bypass. The 24-h routine radiological study before oral intake showed a tiny leak, which was treated by NPO and I.V. fluids. After 5 days, despite output reduction, total parenteral nutrition was commenced. After 8 ...

OBJECT: The aim of this study was to assess whether glue-induced occlusion of the draining vein predicts permanent closure of the fistula following embolization of spinal dural arteriovenous fistulas (SDAVFs). METHODS: Between 1994 and 2004, 36 consecutive patients with an SDAVF were treated at the authors' institution. Twelve patients underwent ...

This report describes the case of a man who presented with fever, weight loss, and Streptococcus mitis septicemia. He was found to have congenital bilateral coronary artery fistula, a rare condition. There was no evidence of vegetation on the heart valves on transthoracic or transesophageal echocardiography. Instead, transesophageal echocardiography showed ...

Many studies have demonstrated that functioning AVFs provide better vascular access outcomes compared to prosthetic devices. In April 2004, the Centers for Medicare and Medicaid Services (CMS) launched a "safe vascular access through collaborative fistula first initiative" (CMS, 2004). This breakthrough proposal cites studies that show increased mortality in patients ...

Aortoesophageal fistula secondary to thoracic aneurysm is rare and is usually fatal without prompt surgical intervention. A 79-year-old man with significant comorbidities and previous cancer surgery was admitted on an emergency basis because of the suspicion of a ruptured thoracic aortic aneurysm. Computed tomographic scan followed by angiography demonstrated a ...

Coronary arterio-venous fistula (CAVF) is a rare coronary artery anomaly. We demonstrated the rare findings of a large congenital aorto-right atrial fistula with initial presentation of heart failure symptoms. Transthoracic echocardiography and transesophageal echocardiography made the accurate diagnosis. Further haemodynamic and angiographic study proved this large CAVF with extraordinary oxygen ...

High flow priapism is a rare pathology resulting mainly from trauma to the perineum leading to arterial-lacunar fistula. Management includes arterial embolization using absorbable material, as well as conservative approach. In this case, the effect of prolonged semi-erection in prepubertal high flow priapism on increased penile size is discussed.

A 45-year old man was admitted to our hospital with chest pain occurring suddenly upon exercise and disappearing with rest within several minutes. A continuous murmur was heard at the upper sternum border. Conventional electrocardiography showed no evidence of myocardial ischemia. Coronary angiography and cardiac catheterization demonstrated a fistula originating ...

To report a technique for correction of atresia ani and rectovestibular fistula with fistula preservation, and outcome in 2 dogs. Case report. Two intact female puppies. The fistula was approached by episiotomy. A vertical median perineal incision was made starting dorsal to the anal region and extended to surround the ...

OBJECTIVES: To describe a modification in brachio-cephalic fistula formation for prevention of dialysis access-associated steal syndrome (DASS). DESIGN: Short report. MATERIALS: From September 2001 to December 2003, 32 upper arm autogenous fistulae were formed using the 'extension technique' in patients at high-risk for developing DASS i.e. diabetics. METHODS: In this ...

Ruptured false iliac aneurysms carry high mortality of up to 57%. It should be suspected whenever a patient who had previous aortic aneurysm repaired presents with bizarre lower abdominal symptoms. In the literature, different presentations have been reported, e.g progressive hydronephrosis, small intestinal obstruction, chronic venous insufficiency, arterio-venous fistula, and ...

A 50-year-old woman complained of hoarseness and chest X-ray demonstrated a widening of the superior mediastinum. Computed tomography scanning and aortography demonstrated aneurysmal dilatation at the innominate artery. Coronary arteriography showed a coronary pulmonary artery fistula originating from the left anterior descending artery. The surgical procedure was prosthetic bifurcated bypass ...

Local complications after femoral arterial catheterization, such as hematomas, pseudoaneurysms, arteriovenous fistulas (AV fistulas), and arterial occlusions, are becoming more common, with the growing number of complex invasive procedures being undertaken, especially in older and sicker patients. Newer percutaneous techniques are being developed to treat these. Covered stents are an ...

Ischemic changes and acute or subacute cardiac failure after arterial switch operation generally results from imperfect transfer of coronary arteries to the neoaorta. Peroperative and early postoperative myocardial ischemia is the main cause of death in these patients. We present an unusual cause of myocardial ischemia and cardiac failure after ...

We present a patient with aortic arch-left innominate vein (LIV) fistula diagnosed by transesophageal echocardiography. Also, an interrupted linear echo was noted within the dilated LIV with flow signals moving across the area of interruption, suggestive of left innominate vein pseudo-aneurysm or dissection. The patient subsequently underwent successful surgical repair ...

Coronary arteriovenous fistula is a rare congenital heart disease. A 71-year-old woman suffered from heart failure due to massive coronary arteriovenous fistulae from the right coronary artery and left circumflex artery to the coronary sinus. Using the off-pump technique, we successfully performed Starfish-assisted obliteration of the fistulae. Intraoperative transesophageal echocardiography ...

Aortoenteric fistula is defined as a communication between the aorta and any adjacent segment of the bowel. It may be primary or secondary. The former occurs de novo in patients with intestinal or vascular diseases, whereas secondary aortoenteric fistula is a rare and dreadful complication of aortic reconstruction with vascular ...

We present a review of our single-institution experience, over 19 years, with aortobronchial and aortoesophageal fistulae due to descending thoracic aortic aneurysm. We conducted a retrospective chart review of 10 cases involving surgery for aortobronchial and aortoesophageal fistulae in our clinic from February 1985 through October 2004. Pathologic or predisposing ...

A 55-year-old man presented with a case of postoperative enterocutaneous fistula with anastomotic stenosis after a Billroth I operation that was resistant to conservative treatment. This fistula was successfully treated with the placement of a covered metallic stent under fluoroscopic guidance. To our knowledge, this is the first report of ...

Coronary artery fistulas are rare congenital anomalies. Although they constitute the most common form of hemodynamically significant coronary malformation, the incidence is around 0.002% in the general population. We report the successful surgical closure of a very large coronary artery fistula, originating from the left coronary artery and draining into ...

Carotid-cavernous sinus fistulas presenting signs and symptoms contralateral to the arterial supply of the fistulas are not uncommon. We describe a thoroughly documented case of an orbital arteriovenous fistula with symptoms exclusively contralateral to the arterial source, a rarer entity. A carotid angiography performed on a patient who presented a ...

Aorto-right ventricular fistulas are defects of the aortic wall in the area above the right coronary cusp, where it separates aorta and right ventricular outflowtract. Often, these injuries are due to trauma or infective endocarditis. We report an occasional finding of such a fistula, without these causes. There were no ...

The National Kidney Foundation's Dialysis Outcomes Quality Initiative recommends an ideal 3- to 4-month arteriovenous fistula (AVF) maturation period prior to cannulation. This recommendation may be misinterpreted by practicing nephrologists to mean that they should wait 3 months before performing a clinical assessment of the AVF. Such a delay in ...

BACKGROUND: Congenital coronary artery fistulas, a subgroup of anomalies of the coronary arteries, are an extremely rare cardiac defect. Most patients are asymptomatic, and if symptoms are presented, they depend on the underlying anatomy. Knowledge of those fistulas is important for prognosis and management. METHODS: Thirteen adult patients with congenital ...

Tracheoinnominate artery fistula remains an uncommon, highly fatal complication of tracheostomy and peritracheal pathology. Endovascular placement of a covered stent can provide control of the fistula. Depending on the conditions of the trachea and peritracheal tissues, the fistula may heal or the stent may become infected and/or further erode into ...

Coronary arteriovenous fistula is a rare congenital anomaly that is seen in 0.1 % to 0.2% of coronary angiograms. Aneurysmal formation in the fistula is even rarer. We report a case of congenital circumflex arteriovenous fistula with aneurysmal formation just near its termination in the pulmonary artery, associated with atherosclerotic ...

We describe the case of a 57-year-old man with severe refractory hypoxemia, despite receiving ventilation therapy with 100% oxygen, following a gunshot wound to his left chest. A limited CT scan of the chest with contrast raised the suspicion of an arteriovenous (AV) fistula. Contrast-enhanced transthoracic echocardiography confirmed the presence ...

BACKGROUND: Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle. CASE PRESENTATION: We describe a case of female patient with severe aortic stenosis ...

Aorto-atrial fistulas (AAF) are rare but important pathophysiologic conditions of the aorta and have varied presentations such as acute pulmonary edema, chronic heart failure and incidental detection of the fistula. A variety of mechanisms such as aortic dissection, endocarditis with pseudoaneurysm formation, post surgical scenarios or trauma may precipitate the ...

Coronary artery fistula is often considered to be a benign and rare congenital anomaly. It is usually an incidental finding encountered during routine cardiac catheterization. We report a case of a patient presenting with endocarditis involving a large coronary artery fistula connecting an aneurysmal circumflex coronary artery to the coronary ...

We present a rare surgical case of aorto-right atrial fistula caused by type A aortic dissection in an 85-year-old man. Complaints included progressive general fatigue and anorexia caused by right side heart failure. However, there were no symptoms attributable to onset of the aortic dissection. A diagnosis of aorto-right atrial ...

We report the cases of three patients diagnosed with dural arteriovenous fistula (DAVF) and cortical venous reflux (CVR). All were treated by transarterial endovascular embolization. Residual shunting and cortical venous drainage continued to be present at the end of the treatment procedure, despite the fact that during endovascular embolization glue ...

BACKGROUND: A well-functioning mature arteriovenous fistula is essential for the maintenance of haemodialysis in patients with chronic renal failure. The Brescia-Cimino arteriovenous fistula has the best survival characteristics and low rate of complications. The most common reason of fistula failure is thrombosis caused by stenosis. Colour Doppler ultrasonography has proven ...

BACKGROUND: Vascular access stenosis is a frequent problem in hemodialysis patients. There is little published literature comparing the features of stenosis between arteriovenous fistulas and grafts, relative outcomes of elective angioplasty, and clinical factors predictive of access patency after angioplasty. METHODS: Prospective data were collected for all patients referred for ...

BACKGROUND: In order to extend the availability of each extremity as an access site for long-term dialysis, we created a brachiobasilic fistula by superficialization of the basilic vein, which had previously been arterialized. In this work, we present the preliminary results of this procedure. METHODS: Patients with prior forearm arteriovenous ...

BACKGROUND: Despite several modifications to the original design, patency rates of radiocephalic arteriovenous fistulas have changed little since the first report in 1966. The use of non-penetrating clips for vascular anastomosis on the outcome of such fistulas was studied. METHODS: Between January 2000 and August 2003, 107 primary radiocephalic fistulas ...

BACKGROUND: The upper-arm native arteriovenous fistula for hemodialysis (HD) vascular access is an important option in the long-term HD population. This single-center cohort study evaluated intra-access blood flow (Q AC) in 3 variants of newly created upper-arm fistulae. METHODS: Fifty-three patients with mature, working, upper-arm fistulae composed of brachial artery ...

High flow priapism is mainly caused by traumatic arteriocavernous fistulas. The standard therapy is a transcatheter embolization of the fistula. This study analyzes the combined approach of arteriography and color Doppler ultrasound during the embolization procedure. During the arteriography procedure, a perineal color Doppler ultrasound examination of the fistula was ...

This article presents a case report of a 79-year-old patient who was suffering from a large femoral arteriovenous fistula and a stenosis of the external iliac artery and who was treated successfully with stent grafts. The fistula, which consisted of three parts, was caused by a percutaneous transluminal coronary angioplasty. ...

Two patients with symptomatic congenital portal vein (PV) fistulas (one case of PV-right hepatic vein fistula and one case of PV-inferior vena cava fistula) causing hepatopulmonary syndrome (hepatic dysfunction, lung vascular alteration in the form of arteriovenous shunts, and hypoxemia) were successfully treated with the Amplatzer patent ductus arteriosus (PDA) ...

We report an unusual case of presumed posttraumatic chronic proximal descending aneurysm associated with a fistula into the pulmonary artery. Review of the literature showed that a fistula of the descending aorta into the pulmonary artery is uncommon and that only a few patients have survived. This rare entity is ...