Document Detail


Congenital circumflex artery-coronary sinus fistula in an adult female associated with severe mitral regurgitation and myelodysplasy--case report and review of the literature.
MedLine Citation:
PMID:  21106021     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary artery fistulas are uncommon anomalies. They occur in 0.1-0.2% of patients undergoing coronary arteriography. The origin of the fistulas is the right coronary artery followed by the left anterior descending and lastly by the circumflex artery (17%). Termination into the right heart side occurs in 90% of cases. Termination into the coronary sinus is rare in 3% of cases. Circumflex artery-coronary sinus fistulas are even rarer.
DESIGN: A single case report and literature review between 1993 and 2007.
RESULTS: We describe a 76-year-old female, who was analyzed for dyspnea on exertion (DOE) and chronic fatigue, with known myelodysplastic syndrome and an aneurysmal circumflex coronary artery-coronary sinus fistulous connection associated with severe mitral regurgitation. Mitral valve replacement using a bioprosthesis was performed as well as ligation of the fistula. The postoperative course was complicated with cardiac tamponade, which was successfully drained.
CONCLUSION: Our patient presented with chronic fatigue and DOE and was found to have a coronary artery fistula and severe mitral regurgitation associated with known myelodysplasia. Conventional coronary angiography failed to demonstrate the entire fistula characteristics (origin, pathway, and outflow). Multidetector computed tomography was complementary to demonstrate the complex anatomy of the fistula. The fistula was surgically ligated in combination with mitral valve replacement. She remains well.
Authors:
Salah A M Said; Aize van der Sluis; Kenneth Koster; Hauw Sie; Ghada M M Shahin
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Congenital heart disease     Volume:  5     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-11-25     Completed Date:  2011-03-10     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  599-606     Citation Subset:  IM    
Copyright Information:
© 2010 Copyright the Authors. Congenital Heart Disease © 2010 Wiley Periodicals, Inc.
Affiliation:
Hospital Group Twente, Department of Cardiology, Hengelo, The Netherlands. samsaid@home.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Arteriovenous Fistula / complications*,  radiography,  surgery
Bioprosthesis
Cardiac Tamponade / etiology
Coronary Angiography / methods
Coronary Sinus / abnormalities*,  radiography,  surgery
Coronary Vessel Anomalies / complications*,  radiography,  surgery
Dyspnea / etiology
Fatigue / etiology
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / adverse effects,  instrumentation
Humans
Ligation
Mitral Valve Insufficiency / complications*,  surgery
Myelodysplastic Syndromes / complications*
Prosthesis Design
Severity of Illness Index
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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