Cambridge City Publishers
  • info.clinical@cardiologycasereportsjournal.org
  • CB1 OBG, Cambridge City, UK
  • Submit Manuscript

Article Details

Case Report
Volume 4, Issue 1 (February Issue)

Rare Symptomatic Fistula from Distal LAD Territories Drained into Right Ventricle: A Case Report

Bashir Ahmed1*, Mohamed Elhakim2, Ahmad Awad3, Emmanouil Chourdakis4, Mohammed Saad5 and Abdelrahman Elhakim6

1Interventional Cardiology Consultant, Helios Klinikum Bonn/Rhein-Sieg, Germany
2Intensive Care Medicine Department, The Royal Prince Alfred Hospital, Sydney, Australia
3Interventional Cardiologist, St. Georg Klinikum Eisenach gGmbH, Eisenach
4Interventional Cardiologist, Heart Center Lahr, Hohbergweg 2, Germany
5Interventional Cardiology Consultant, Schleswig-Holstein University Hospital-Kiel, Germany
6Interventional Cardiology Consultant, Schoen Hospital Neustadt, Germany

*Corresponding author: Bashir Ahmed, Interventional Cardiology Consultant, Helios Klinikum Bonn/Rhein-Sieg, Von-Hompesch-Str. 1, 53123 Bonn, Germany.
E-Mail: bashir_7499@yahoo.com

Received: January 02, 2024; Accepted: January 29, 2024; Published: February 05, 2024

Citation: Ahmed B, Elhakim M, Awad A, et al. Rare Symptomatic Fistula from Distal LAD Territories Drained into Right Ventricle: A Case Report. Case Rep Clin Cardiol J. 2024; 4(1): 144.

Rare Symptomatic Fistula from Distal LAD Territories Drained into Right Ventricle: A Case Report
Abstract

Introduction: Coronary-cameral fistulas (CCF) are anomalous connections between one coronary artery, most commonly the right coronary, then the left or circumflex, and a cardiac chamber, most commonly the right ventricle or right atrium. However, iatrogenic CCF or coronary arteriovenous fistula can occur after coronary artery perforation. Indications for closure are significant left to right shunt, congestive heart failure due to ventricular volume overload, myocardial ischemia due to coronary steal phenomenon, prevention of endarteritis or rupture.

Case Summary: A 83-year-old female patient presented with right sided heart failure. Transthoracic echocardiography revealed unusual large fistula at tricuspid annulus, which drained into right ventricle. Cine images confirmed fistula connection to distal LAD coronary territories. Decision to treat it conservatively due to patient`s comorbidity, atypical anatomy and failure risk to close it effectively.

Conclusion: Coronary-cameral fistulas in unusual sites can be easily detected and assessed by the transthoracic echocardiography. The decision to treat is a case-by-case based on balancing the symptoms, the risk of the fistula, and the risk of complications. Careful planning of the procedure is mandatory and successful closure can be obtained by transcatheter or surgical approach.

Keywords: Fistula; Transthoracic echocardiography; Heart failure; Fistula closure devices