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A Diagnostic and Therapeutic Dilemma: An Unusual Complication of a Coronary Artery Bypass Surgery
Author(s) -
Bernier Martin,
Valenti David,
Rabinovitch Mark,
Huynh Thao
Publication year - 2007
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2007.00439.x
Subject(s) - medicine , mediastinitis , coronary artery bypass surgery , artery , complication , surgery , mammary artery , fistula , percutaneous , pulmonary artery , cardiology , radiology
We report a diagnostic and therapeutic challenge involving an unusual coronary artery bypass complication. This is the first report of extensive systemic‐pulmonary shunts involving the left internal mammary artery, lateral thoracic and intercostal arteries following coronary artery bypass surgery. Although internal mammary to pulmonary arterial fistula are uncommon complications of coronary artery bypass surgery, clinicians should keep this in mind in managing patients with unexplained exertional dypsnea, especially with prior history of intrathoracic inflammation, mediastinitis, and disruption of the pleura. We also discuss various therapeutic approaches including surgical and percutaneous interventions.