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A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair

BACKGROUND: Isolated coronary arteriovenous fistulas are extremely rare, accounting for 0.08–0.4% of all congenital heart disease. Closure of the fistula is recommended in cases of large dimensions, relevant left–right shunt, or ischaemic events. Thrombosis of the coronary aneurysms may occur as a p...

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Autores principales: Poretti, Giulia, Lo Rito, Mauro, Varrica, Alessandro, Frigiola, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793215/
https://www.ncbi.nlm.nih.gov/pubmed/33447712
http://dx.doi.org/10.1093/ehjcr/ytaa297
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author Poretti, Giulia
Lo Rito, Mauro
Varrica, Alessandro
Frigiola, Alessandro
author_facet Poretti, Giulia
Lo Rito, Mauro
Varrica, Alessandro
Frigiola, Alessandro
author_sort Poretti, Giulia
collection PubMed
description BACKGROUND: Isolated coronary arteriovenous fistulas are extremely rare, accounting for 0.08–0.4% of all congenital heart disease. Closure of the fistula is recommended in cases of large dimensions, relevant left–right shunt, or ischaemic events. Thrombosis of the coronary aneurysms may occur as a postoperative complication. CASE SUMMARY: We report a case of a coronary fistula between the circumflex artery and coronary sinus with giant aneurysm. After a failed percutaneous closure attempt, the patient was surgically treated without major postoperative complications. Despite therapeutic anticoagulation and antiplatelet therapy, she presented at clinical follow-up with thrombosis of the dilated coronary artery without signs or symptoms of ischaemia. DISCUSSION: Management of coronary artery fistula may be challenging in cases in which initial percutaneous closure is unsuccessful. This particular case also highlights the importance of close follow-up, despite optimal therapy, to detect potentially lethal complications related to the low flow in the dilated coronary aneurysm.
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spelling pubmed-77932152021-01-13 A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair Poretti, Giulia Lo Rito, Mauro Varrica, Alessandro Frigiola, Alessandro Eur Heart J Case Rep Case Reports BACKGROUND: Isolated coronary arteriovenous fistulas are extremely rare, accounting for 0.08–0.4% of all congenital heart disease. Closure of the fistula is recommended in cases of large dimensions, relevant left–right shunt, or ischaemic events. Thrombosis of the coronary aneurysms may occur as a postoperative complication. CASE SUMMARY: We report a case of a coronary fistula between the circumflex artery and coronary sinus with giant aneurysm. After a failed percutaneous closure attempt, the patient was surgically treated without major postoperative complications. Despite therapeutic anticoagulation and antiplatelet therapy, she presented at clinical follow-up with thrombosis of the dilated coronary artery without signs or symptoms of ischaemia. DISCUSSION: Management of coronary artery fistula may be challenging in cases in which initial percutaneous closure is unsuccessful. This particular case also highlights the importance of close follow-up, despite optimal therapy, to detect potentially lethal complications related to the low flow in the dilated coronary aneurysm. Oxford University Press 2020-10-27 /pmc/articles/PMC7793215/ /pubmed/33447712 http://dx.doi.org/10.1093/ehjcr/ytaa297 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Reports
Poretti, Giulia
Lo Rito, Mauro
Varrica, Alessandro
Frigiola, Alessandro
A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
title A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
title_full A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
title_fullStr A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
title_full_unstemmed A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
title_short A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
title_sort case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793215/
https://www.ncbi.nlm.nih.gov/pubmed/33447712
http://dx.doi.org/10.1093/ehjcr/ytaa297
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