Document Detail

Surgical repair of complicated coronary arteriovenous fistula and coronary artery aneurysm in an elderly patient after 26 years of conservative therapy.
MedLine Citation:
PMID:  21063881     Owner:  NLM     Status:  In-Data-Review    
We describe a rare case of surgical repair of a coronary artery aneurysm with arteriosclerotic changes accompanied by coronary arteriovenous fistula (CAVF) after 26 years of conservative therapy. A 71-year-old woman, diagnosed with CAVF 26 years previously, was admitted to our hospital for general fatigue and dyspnea on exertion. Physical examinations revealed that the CAVF originated from the distal portion of the left circumflex artery (LCX), draining into the coronary sinus (CS); it affected the coronary artery aneurysm with arteriosclerotic changes and was calcified from the left coronary main trunk to the distal portion of the LCX. Treatment without resection of the calcified coronary aneurysm was suggested because of fear of excessive bleeding. The CAVF was closed directly from inside the dilated coronary sinus under cardiopulmonary bypass. The dilated ostium of the left coronary artery was closed using a Xenomedica patch. Coronary artery bypass grafting was performed in the left anterior descending artery (LAD) and posterolateral branch (PL) of the LCX using saphenous vein grafts. Postoperatively, the coronary aneurysm was spontaneously thrombosed for low blood flow. The bleeding might have been uncontrolled if the arteriosclerotic and calcified coronary aneurysm had been incised. Therefore, we successfully thrombosed the calcified coronary aneurysm without resection, after reducing the systemic blood flow to the coronary aneurysm and sustaining the coronary blood flow, performed with CABG.
Yuki Nakayama; Akira Shikawa; Yoshikazu Ayusawa; Susumu Hosoda; Kennichi Muroi; Masahiro Yagi; Shinya Fuji; Hiroshi Kobayashi; Kannichi Fujimori; Yukiko Shimatani; Yujin Shimoyama; Tatsuro Uchida
Publication Detail:
Type:  Journal Article     Date:  2010-11-10
Journal Detail:
Title:  Heart and vessels     Volume:  26     ISSN:  1615-2573     ISO Abbreviation:  Heart Vessels     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-03-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  111-6     Citation Subset:  IM    
Department of cardiovascular surgery, Sendai Cardiovascular Center, 21-1Honda-cho, Izumi-ku, Sendai, Miyagi, 981-3107, Japan,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Timing of continuous veno-venous hemodialysis in the treatment of acute renal failure following card...
Next Document:  Cell membrane stretch activates intermediate-conductance Ca(2+)-activated K (+) channels in arterial...