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Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report

BACKGROUND: With an incidence of less than 1%, a Coronary Artery to Pulmonary Artery fistula (CAPF) is a rare coronary anomaly that causes heart failure. It causes a left to right cardiac shunt. While guidelines favor surgical correction in symptomatic patients, we present a challenging case with mu...

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Autores principales: George, Blessen, Sood, Michael R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918961/
https://www.ncbi.nlm.nih.gov/pubmed/35295191
http://dx.doi.org/10.1177/20480040221082905
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author George, Blessen
Sood, Michael R
author_facet George, Blessen
Sood, Michael R
author_sort George, Blessen
collection PubMed
description BACKGROUND: With an incidence of less than 1%, a Coronary Artery to Pulmonary Artery fistula (CAPF) is a rare coronary anomaly that causes heart failure. It causes a left to right cardiac shunt. While guidelines favor surgical correction in symptomatic patients, we present a challenging case with multiple cardio-thoracic pathologies. CASE PRESENTATION: We present a 38-year-old obese male with persistent atrial fibrillation (AF). He presented to our hospital in decompensated heart failure and AF with rapid ventricular response. He was found to have a CAPF, a bicuspid aortic valve and left lung hypoplasia in the presence of severely reduced left ventricular systolic dysfunction. The patient subsequently underwent various cardiac testing demonstrating advanced anatomical and physiologic involvement of his CAPF, including suggested coronary steal. Despite some indications for percutaneous or surgical referral, we optimized his AF and congestive heart failure in lieu of formulating a treatment strategy for his CAPF and other abnormalities. CONCLUSION: This report illustrates a case of a young adult who presented in decompensated heart failure with newly diagnosed left ventricular systolic function and rapid AF, who had a triad of congenital defects including a CAPF, a bicuspid aortic valve and left lung hypoplasia. To the best of our knowledge, this triad of defects is unreported. This case highlights the clinical approach in the evaluation of a cardiac shunt and it's management strategies in the presence of multiple cardio-thoracic comorbidities.
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spelling pubmed-89189612022-03-15 Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report George, Blessen Sood, Michael R JRSM Cardiovasc Dis Case Report BACKGROUND: With an incidence of less than 1%, a Coronary Artery to Pulmonary Artery fistula (CAPF) is a rare coronary anomaly that causes heart failure. It causes a left to right cardiac shunt. While guidelines favor surgical correction in symptomatic patients, we present a challenging case with multiple cardio-thoracic pathologies. CASE PRESENTATION: We present a 38-year-old obese male with persistent atrial fibrillation (AF). He presented to our hospital in decompensated heart failure and AF with rapid ventricular response. He was found to have a CAPF, a bicuspid aortic valve and left lung hypoplasia in the presence of severely reduced left ventricular systolic dysfunction. The patient subsequently underwent various cardiac testing demonstrating advanced anatomical and physiologic involvement of his CAPF, including suggested coronary steal. Despite some indications for percutaneous or surgical referral, we optimized his AF and congestive heart failure in lieu of formulating a treatment strategy for his CAPF and other abnormalities. CONCLUSION: This report illustrates a case of a young adult who presented in decompensated heart failure with newly diagnosed left ventricular systolic function and rapid AF, who had a triad of congenital defects including a CAPF, a bicuspid aortic valve and left lung hypoplasia. To the best of our knowledge, this triad of defects is unreported. This case highlights the clinical approach in the evaluation of a cardiac shunt and it's management strategies in the presence of multiple cardio-thoracic comorbidities. SAGE Publications 2022-03-10 /pmc/articles/PMC8918961/ /pubmed/35295191 http://dx.doi.org/10.1177/20480040221082905 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
George, Blessen
Sood, Michael R
Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report
title Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report
title_full Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report
title_fullStr Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report
title_full_unstemmed Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report
title_short Coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: A case report
title_sort coronary-pulmonary artery fistula with lung hypoplasia and a bicuspid aortic valve: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918961/
https://www.ncbi.nlm.nih.gov/pubmed/35295191
http://dx.doi.org/10.1177/20480040221082905
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