Cor Vasa 2023, 65(3):550-554 | DOI: 10.33678/cor.2022.078

(Left-right short circuit in an adult woman between the left coronary artery and the sinus coronarius caused by a giant fistula)

Zuzana Komorová^a, Martin Novák^a, Jiří Seménka^a, Věra Feitová^{b, c}, Petr Němec^{d, e}, Lenka Špinarová^a

^a I. interní kardioangiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně, Brno

^b Klinika zobrazovacích metod, Fakultní nemocnice u sv. Anny v Brně, Brno

^c Mezinárodní centrum klinického výzkumu, Fakultní nemocnice u sv. Anny v Brně, Brno

^d Klinika kardiovaskulární a transplantační chirurgie, Lékařská fakulta Masarykovy univerzity, Brno

^e Centrum kardiovaskulární a transplantační chirurgie, Brno

Communication between coronary arteries and large arteries or heart cavities in the form of fistula is a rare anomaly occurring in about 0.1-1.0% of coronarographed patients. Our case report describes a 65-year-old patient admitted to our department for suspicious left-right short circuit. Transesophageal echocardiography was performed and revealed communication between the left coronary artery trunk and the coronary sinus. Coronary angiography and subsequent CT coronarography confirmed the finding of a gigantic fistula between the ACS strain and the coronary sinus. Due to the extent of the short circuit, cardiac surgery was indicated - fistula ligation was performed, without subsequent revascularization. In the following course, the patient's subjective condition improved whereas dyspnea and pulmonary hypertension decreased.

Keywords: Coronarography, Coronary artery fistula (CAF), Echocardiography

Received: July 4, 2022; Revised: July 4, 2022; Accepted: July 7, 2022; Published: June 20, 2023  Show citation