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Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review

Coronary artery fistulas (CAFs) are found in 0.3–0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present...

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Autores principales: Iyer, Praneet, Yelisetti, Rishitha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637639/
https://www.ncbi.nlm.nih.gov/pubmed/29046757
http://dx.doi.org/10.1080/20009666.2017.1369380
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author Iyer, Praneet
Yelisetti, Rishitha
author_facet Iyer, Praneet
Yelisetti, Rishitha
author_sort Iyer, Praneet
collection PubMed
description Coronary artery fistulas (CAFs) are found in 0.3–0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle. In both the cases, No intervention was performed. Of the congenital fistulas, two major groups are identified: solitary CAFs or coronary artery-left ventricular multiple micro-fistulas (CALVMMFs). Noninvasive techniques such as transthoracic echocardiography, transesophageal echocardiography and magnetic resonance imaging are becoming increasingly popular for diagnosis and follow-up of CAFs. Despite the advent of these newer non-invasive modalities, coronary angiography remains the gold standard for diagnosis. Treatment of CAFs is indicated when the patients are symptomatic with left ventricular volume overload, myocardial ischemia, left ventricular dysfunction or in the presence of a large or increasing left-to-right shunt. If the fistula is small and hemodynamically insignificant, it can be managed with conservative management. Multiple left anterior descending to left ventricle (LV) fistulas are extremely rare and, as per our literature review, we noted only a few case reports of coronary artery fistulas between branches of LAD and left ventricle.
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spelling pubmed-56376392017-10-18 Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review Iyer, Praneet Yelisetti, Rishitha J Community Hosp Intern Med Perspect Case Report Coronary artery fistulas (CAFs) are found in 0.3–0.8% of patients who undergo coronary angiography. CAFs are defined as single or multiple, small or large direct communications that arise from one or more coronary arteries and enter into one of the four cardiac chambers or major vessels. We present two cases of multiple coronary artery fistulas arising from diagonal and left anterior descending (LAD) branches of left coronary artery draining into the left ventricle. In both the cases, No intervention was performed. Of the congenital fistulas, two major groups are identified: solitary CAFs or coronary artery-left ventricular multiple micro-fistulas (CALVMMFs). Noninvasive techniques such as transthoracic echocardiography, transesophageal echocardiography and magnetic resonance imaging are becoming increasingly popular for diagnosis and follow-up of CAFs. Despite the advent of these newer non-invasive modalities, coronary angiography remains the gold standard for diagnosis. Treatment of CAFs is indicated when the patients are symptomatic with left ventricular volume overload, myocardial ischemia, left ventricular dysfunction or in the presence of a large or increasing left-to-right shunt. If the fistula is small and hemodynamically insignificant, it can be managed with conservative management. Multiple left anterior descending to left ventricle (LV) fistulas are extremely rare and, as per our literature review, we noted only a few case reports of coronary artery fistulas between branches of LAD and left ventricle. Taylor & Francis 2017-09-19 /pmc/articles/PMC5637639/ /pubmed/29046757 http://dx.doi.org/10.1080/20009666.2017.1369380 Text en © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Iyer, Praneet
Yelisetti, Rishitha
Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review
title Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review
title_full Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review
title_fullStr Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review
title_full_unstemmed Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review
title_short Multiple left anterior descending coronary artery to left ventricular fistula – A case series and literature review
title_sort multiple left anterior descending coronary artery to left ventricular fistula – a case series and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637639/
https://www.ncbi.nlm.nih.gov/pubmed/29046757
http://dx.doi.org/10.1080/20009666.2017.1369380
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