Chonnam Med J.  2010 Dec;46(3):192-194. 10.4068/cmj.2010.46.3.192.

Coronary Arteriovenous Fistulas with Aneurysm

• Hong MJ
• Hwang SH
• Noh HM
• Hong KH
• Kim SJ
• Kim JB
• Park CY
• Kang WY
• Kim W

• KMID: 2116775
• DOI: http://doi.org/10.4068/cmj.2010.46.3.192

Abstract

Coronary artery fistula with aneurysm is an infrequent vascular anomaly. Echocardiography and angiography have traditionally been used as diagnostic tools for coronary artery fistulas. However, new imaging modalities, such as multi-detector computed tomography (MDCT), can now be used to noninvasively determine the anatomy of an abnormal coronary artery accurately and to facilitate the formulation of appropriate management strategies. In this case, two huge coronary arteriovenous fistulas with aneurysmal changes were observed on 2D-echocardiography and coronary angiography performed on a 72-year-old female. The anatomy of the coronary arteriovenous fistula was then determined in detail by 64-slice MDCT angiography.

Keyword

Coronary vessel anomalies; Coronary vessels; Pulmonary vein; Heart failure; Tomography, X-ray computed

MeSH Terms

Aged
Aneurysm
Angiography
Arteriovenous Fistula
Coronary Angiography
Coronary Vessel Anomalies
Coronary Vessels
Echocardiography
Female
Fistula
Heart Failure
Humans
Pulmonary Veins
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 2D-Echocardiography shows a dilated left main coronary artery and abnormal color flow at the pulmonary valve level (A) and mid-ventricle level (B). Coronary angiography reveals a huge dilated left main artery with aneurysmal formation drained to the pulmonary trunk (wide arrow) (C) and an abnormal fistula originating from the aorta beside the right coronary artery (narrow arrow) (D). A 64-slice multi-detected computed tomography (MDCT) angiograph shows a markedly dilated left main artery and aneurysmal dilatation of an arteriovenous fistula from the left main artery to the pulmonary trunk and an abnormal vessel originating from the right coronary cusp just beside the origin of the right coronary artery drained to the dilated left main artery (E, F).

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