Ruptured Coronary Aneurysm with a Congenital Coronary Arteriovenous Fistula / 日本心臓血管外科学会雑誌

An 83-year-old man was transferred to our hospital with cardiac tamponade and suspected cardiac tumor detected by enhanced CT. Coronary angiography showed a coronary aneurysm of 50 mm ID on the left circumflex artery. An emergency surgery was performed to excise the aneurysm, and a fresh thrombus occupying the efferent artery was observed. Both the afferent and efferent vessels were closed by suture. The patient made an otherwise uneventful recovery. This case featured a fresh red thrombus formed in fistulous outflow of the coronary aneurysm that seemed a direct cause of rupture.

A Case of Percutaneous Transcatheter Coil Embolization for Congenital Coronary Arteriovenous Fistula

We report a case of 70-year-old woman who had bilateral coronary arteriovenous fistula(CAVF) and treated with percutaneous transcatheter coil embolization. Enlarged LV and reduced global LV systolic function were demonstrated on transthoracic echocardiography. Coronary angiography revealed a large coronary arteriovenous fistula from the right coronary artery to the main pulmonary artery and a small fistula from the left coronary artery to the main pulmonary artery. Percutaneous transcatheter coil embolization for CAVF from the right coronary artery to the main pulmonary artery was successfully performed with symptomatic improvement.

Congenital coronary arteriovenous fistula in children: A report of 12 cases and review of the literature.

Twelve children, 6 boys and 6 girls, with congenital coronary arteriovenous fistulas were retrospectively studied. The diagnoses were made at ages ranging from 2 days to 9 years. Three (twenty five per cent) of the patients had congestive heart failure, while the others had no symptoms. Abnormal physical findings included bounding pulse 9 cases (75 per cent), continuous murmur 7 case (58 per cent), pansystolic murmur 3 cases (25 per cent), and to and from murmur 2 cases (17 per cent). Cardiomegaly and increased pulmonary vascularity were demonstrated in the chest X-ray in 66 per cent of the patients. Electrocardiograms showed left ventricular hypertrophy in 58 percent of the patients. Provisional diagnoses of small ventricular septal defect, patent ductus arteriosus or catheterization were necessary in making definite diagnoses in which average Qp : Qs was 1.7:1. Three patients (25 per cent) had other associated lesions i.e. patent ductus arteriosus and/or atrial septal defect. Ten patients received surgical treatment with good results.