| Congenital circumflex artery-coronary sinus fistula in an adult female associated with severe mitral regurgitation and myelodysplasy--case report and review of the literature. | |
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MedLine Citation:
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PMID: 21106021 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Salah A M Said; Aize van der Sluis; Kenneth Koster; Hauw Sie; Ghada M M Shahin |
Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Congenital heart disease Volume: 5 ISSN: 1747-0803 ISO Abbreviation: Congenit Heart Dis Publication Date: 2010 Nov-Dec |
Date Detail:
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Created Date: 2010-11-25 Completed Date: 2011-03-10 Revised Date: 2011-05-05 |
Medline Journal Info:
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Nlm Unique ID: 101256510 Medline TA: Congenit Heart Dis Country: United States |
Other Details:
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Languages: eng Pagination: 599-606 Citation Subset: IM |
Copyright Information:
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© 2010 Copyright the Authors. Congenital Heart Disease © 2010 Wiley Periodicals, Inc. |
Affiliation:
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Hospital Group Twente, Department of Cardiology, Hengelo, The Netherlands. samsaid@home.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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