Coronary artery fistulae (CAF) are classified as abnormalities of a chamber of the heart (coronary-cameral fistula) or any segment of the. Coronary-cameral fistulas are rare congenital malformations, often incidentally found during cardiac catheterizations. The majority of these. Coronary artery fistulas: clinical and therapeutic considerations. Coronary artery to pulmonary artery fistulae with multiple aneurysms: radiological features on dual-source slice . MDCT in the Evaluation of Coronary Cameral Fistula.

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Coronary cameral fistulas Coroary are rare and are characterized by abnormal communication between coronary artery CA and cardiac chamber that usually results from aberrancy of normal embryological development. Coronary angiogram showing a fistula connecting distal left anterior descending artery LAD and first obtuse marginal artery OM1 to the left ventricular cavity.

Incidence, angiographic characteristics, natural history. A 57 year old male smoker, with a fisfula history of hypertension, presented with angina. Coronary artery fistulas in adults: Coronary-cameral fistulas CCFs 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 right atrium RA and ventricle RV voronary left atrium LA and ventricle LV [ 12 ].

Coronary–cameral fistula

The presence or absence of symptoms may be related to the size of the fistula and the site of origin and termination of the fistula. A decade of global experience. Within the entity of CCFs, each subtype has its own specific characteristics such as origin, termination of fistulas and treatment options.


The authors thank Prof. Please check for further notifications by email. Manuscripts were checked for completeness and a meticulous search was performed for fistila termination into any of the cardiac chambers. Dual endocardial pacing fistuoa are appreciated.

Case Reports in Cardiology

Clinical presentation will generally depend on the haemodynamic significance of the anomaly and most commonly coronary artery fistulae are asymptomatic and are found incidentally. Patients in whom focal fistulae with large shunts exist may benefit from closure of the shunt, and if this is to be performed it is probably best done as early as possible.

The majority of these fistulas are congenital in nature but can be acquired secondary to trauma or invasive cardiac procedures. Coronary artery-left ventricular micro-fistulas associated with apical hypertrophic cardiomyopathy.

Three-vessel left-ventricular microfistulization syndrome: A case series and review of the literature adding 11 new cases. Generalized coronary arterio-systemic left ventricular fistula.

While most patients are asymptomatic or have non-specific complaints, bilateral MMFs draining into the LV may remain clinically silent[ 39 ] or may produce diastolic murmur[ 40 ] and diastolic volume overload, mimicking aortic valve insufficiency.

Maas of hospital group Twente is gratefully acknowledged. The cardiac apex was not displaced, and there was no murmur. Mitral valve replacement; N: Citing articles via Web of Science An arterio-capillary variant has also been described.

While congenital MMFs are generally treated conservatively, congenital solitary CCFs may undergo percutaneous occlusion or surgical ligation in the presence of substantial significant shunts. One patient refused further treatment. He reported having an echocardiogram in an outside hospital that showed a tortuous vascular channel along the right atrium concerning for CA aneurysm.


Three patients underwent myocardial perfusion tests 1 was negative and 2 were positive for ischemic changes. Sign In or Create an Account. Severe form of persistent thebesian veins presenting as ischemic heart disease. N Engl J Med.

The mean age was National Center for Biotechnology InformationU.

Coronary-cameral fistulas in adults (first of two parts)

Origin from the distal segment of the involved coronary artery was documented in 5 of the subjects. A complete transthoracic echocardiogram showed left ventricular ejection fraction of 35 percent, moderate global hypokinesis, and mild tricuspid regurgitation.

Dyspnoea on exertion; EF: Transient ischemic attack; VD: Percutaneous therapeutic embolization; RA: There is a left-to-right shunt if termination is to systemic venous side and there is a left-sided volume overload if the termination is in left cardiac chambers.

There were 11 patients with congenital MMFs mean age of A mechanical prosthesis in a porcelain box. Email alerts New issue alert. Myocardial infarction due to multiple coronary-ventricular fistulas.

Percutaneous coronary intervention; PTE: Congenital coronary cameral fistulas vary widely in their clinical presentation. Coronary artery-ventricular multiple micro-fistulas; PCI: Although there is no consensus on treatment of choice of symptomatic fistulae due to its rarity; surgical repair, catheter closure and medical management have been successfully tried.

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