Open AccessPercutaneous, Catheter‐Based Coil Embolization of Coronary Fistula:
Author(s) -
OLDENBURG OLAF,
PHILIPP THOMAS,
FORSTING MICHAEL,
ERBEL RAIMUND
Publication year - 2003
Publication title -
journal of interventional cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.764
H-Index - 51
eISSN - 1540-8183
pISSN - 0896-4327
DOI - 10.1034/j.1600-6143.2003.08053.x
Subject(s) - medicine , cardiology , coronary steal , catheter , angina , chest pain , right coronary artery , fistula , artery , left coronary artery , cardiac catheterization , coronary artery disease , embolization , radiology , myocardial infarction , coronary angiography
A 55‐year‐old male with angina‐like chest pain and positive thallium‐scintigraphy was admitted to our hospital. Cardiac catheterization was performed for suspected coronary artery disease. The coronary angiogram showed no significant epicardial stenosis, but a large coronary fistula, connecting the left anterior descending artery with the pulmonary artery. Swan–Ganz catheter measurements, intracoronary Doppler, and quantitative coronary angiography were used to determine cardiac output, coronary blood flow, and coronary‐to‐pulmonary artery shunt fraction. These measurements showed a hyperdynamic cardiac output of 17 L/min, a coronary blood flow of 140 mL/min in the left anterior descending coronary artery with an estimated shunt fraction of 58% into the pulmonary circulation. Percutaneous, catheter‐based coil embolization was performed to occlude the fistula. After embolization of one coil, coronary angiography showed the fistula's stump only. Cardiac output (9 L/min) and coronary blood flow (48 mL/min) were almost normalized. The patient was discharged from the hospital the day after the procedure. After a 6‐month follow‐up, there were still no complaints, angina‐like symptoms or signs of myocardial ischemia in stress tests . (J Interven Cardiol 2003;16:343–346)