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Images in cardiovascular medicine voluminous left main stem to pulmonary artery fistula: A conservative approach
Author(s) -
Botta Luca,
Amodio Ciro,
Savini Carlo,
Pacini Davide
Publication year - 2020
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/jocs.14483
Subject(s) - medicine , fistula , perioperative , surgery , population , radiology , cardiology , environmental health
The presence of a coronary arteriovenous fistula is almost rare in the adult population, even rare when associated with aortic valve insufficiency. Management and treatment options can vary and depend on a single patient. In our case, a large fistula with a rounded origin started from the roof of the left main stem, just attached to the wall of the aortic root, and finished with a very narrowed end in the pulmonary trunk. Due to its anatomical position and to the potential complications related to a proximal surgical closure as well as the incidental discovery in adult age (without signs or symptoms until the operation), we decided to have a conservative approach, leaving untouched the fistula. No intraoperative, perioperative, and follow‐up signs of myocardial ischemia were observed.