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An unusual case of infective endocarditis involving a right coronary artery to superior vena cava fistula
Author(s) -
Jariwala Ujjval,
Hasan Rani K.,
Thorn Eric M.,
Zakaria Sammy
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25597
Subject(s) - medicine , infective endocarditis , endocarditis , fistula , superior vena cava , asymptomatic , cardiology , complication , myocardial infarction , heart failure , right coronary artery , surgery , artery , persistent left superior vena cava , radiology , coronary sinus , coronary angiography
Coronary artery fistulas (CAFs) are rare and mostly congenital anomalous connections between a coronary artery and a cardiac chamber or great vessel. Most CAFs are small, asymptomatic, and found incidentally during cardiac imaging. However, they can lead to serious complications including myocardial infarction, congestive heart failure, arrhythmias, or fistula rupture. CAFs have been associated with infective endocarditis, but to our knowledge, this complication has never been reported involving an isolated CAF to an otherwise anatomically normal great vessel. We report the first case of this complication in a 49‐year‐old man with a presumed streptococcus vegetation found within an isolated large, tortuous CAF connecting the right coronary artery to the superior vena cava. After completing antibiotic treatment, transcatheter closure of the CAF was performed. Since then, the patient has remained symptom‐free. This case demonstrates that CAF closure is feasible following CAF‐associated endocarditis, and that closure may represent a viable strategy for reducing risk of recurrent infection. © 2014 Wiley Periodicals, Inc.