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Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery
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MODEL
Hellenic Journal of Cardiology (2016) xx, 1e2
Available online at www.sciencedirect.com
ScienceDirect journal homepage: http://www.journals.elsevier.com/ hellenic-journal-of-cardiology/
Letter to the Editor
Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery
KEYWORDS Coronary arteriovenous fistula; Arteriovenous fistula recurrence
A 55 years old female patient with exertional angina pectoris and positive stress test underwent a diagnostic coronary angiography which showed bilateral coronary arteriovenous fistulae from the right coronary and
circumflex arteries to the pulmonary artery (Fig. 1A, B). Invasive transcatheter coil occlusion of the fistulae was unsuccessful so she was referred to surgery where with an on-pump procedure and the use of aortic cross-clamp and cardioplegic arrest, clipping of the origins of the arteriovenous fistulae was performed with success. (Fig. 1C, D). Three years later in a follow-up control coronary angiography that was done due to progressive exertional dyspnoea of the patient, partial recurrence of the arteriovenous fistulae in the circumflex artery was diagnosed (Fig. 1E, F). Recurrence rate is from 9%e25% according to the treatment method.1 Finally, in patients presenting with symptoms of chronic heart failure and pulmonary hypertension,2 the
Figure 1 A,B: Preoperative diagnostic coronary angiography: A, RAO view of the circumflex artery. B, LAO view of the right coronary artery. Arrows show the arteriovenous fistulae. C,D: Postoperative control coronary angiography: A, RAO view of the circumflex artery. B, LAO view of the right coronary artery. Arrows show the surgical clips. E,F: Follow-up control coronary angiography: A, RAO view of the circumflex artery. B, LAO view of the right coronary artery. Arrow in E shows the partial recurrence of arteriovenous fistulae, in F the occluded arteriovenous fistula.
Peer review under responsibility of Hellenic Cardiological Society. http://dx.doi.org/10.1016/j.hjc.2016.08.002 1109-9666/ª 2016 Hellenic Cardiological Society. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Please cite this article in press as: Gasparovic I, et al., Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery, Hellenic Journal of Cardiology (2016), http://dx.doi.org/ 10.1016/j.hjc.2016.08.002
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Letter to the Editor
Figure 1
differential diagnosis of coronary arteriovenous fistulae should be consider.
Conflict of interest The authors declare no conflict of interest.
References 1. Said SA, Nijhuis RL, Op den Akker JW, et al. Diagnostic and therapeutic approach of congenital solitary coronary artery fistulas in adults: Dutch case series and review of literature. Neth Heart J. 2011;19(4):183e191. 2. Kakouros NS, Kakouros SN. Clinical assessment in acute heart failure. Hellenic J Cardiol. 2015;56(4):285e301.
(continued).
Ivo Gasparovic, MD Panagiotis Artemiou, MD, PhD * Vladan Hudec, MD Michal Hulman, MD, PhD Medical Faculty of the Slovak Health University, National Institute for Cardiovascular Diseases, Clinic of Cardiac Surgery, Bratislava, Slovakia *Corresponding author. Dr Panagiotis Artemiou, National Institute of Cardiovascular Diseases, Pod krasnou horkou 1, 83101, Bratislava, Slovakia. Tel.: þ421 917 665774; fax: þ421 259 320287. E-mail address: [email protected] (P. Artemiou) 22 June 2016
Please cite this article in press as: Gasparovic I, et al., Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery, Hellenic Journal of Cardiology (2016), http://dx.doi.org/ 10.1016/j.hjc.2016.08.002
MODEL
Hellenic Journal of Cardiology (2016) xx, 1e2
Available online at www.sciencedirect.com
ScienceDirect journal homepage: http://www.journals.elsevier.com/ hellenic-journal-of-cardiology/
Letter to the Editor
Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery
KEYWORDS Coronary arteriovenous fistula; Arteriovenous fistula recurrence
A 55 years old female patient with exertional angina pectoris and positive stress test underwent a diagnostic coronary angiography which showed bilateral coronary arteriovenous fistulae from the right coronary and
circumflex arteries to the pulmonary artery (Fig. 1A, B). Invasive transcatheter coil occlusion of the fistulae was unsuccessful so she was referred to surgery where with an on-pump procedure and the use of aortic cross-clamp and cardioplegic arrest, clipping of the origins of the arteriovenous fistulae was performed with success. (Fig. 1C, D). Three years later in a follow-up control coronary angiography that was done due to progressive exertional dyspnoea of the patient, partial recurrence of the arteriovenous fistulae in the circumflex artery was diagnosed (Fig. 1E, F). Recurrence rate is from 9%e25% according to the treatment method.1 Finally, in patients presenting with symptoms of chronic heart failure and pulmonary hypertension,2 the
Figure 1 A,B: Preoperative diagnostic coronary angiography: A, RAO view of the circumflex artery. B, LAO view of the right coronary artery. Arrows show the arteriovenous fistulae. C,D: Postoperative control coronary angiography: A, RAO view of the circumflex artery. B, LAO view of the right coronary artery. Arrows show the surgical clips. E,F: Follow-up control coronary angiography: A, RAO view of the circumflex artery. B, LAO view of the right coronary artery. Arrow in E shows the partial recurrence of arteriovenous fistulae, in F the occluded arteriovenous fistula.
Peer review under responsibility of Hellenic Cardiological Society. http://dx.doi.org/10.1016/j.hjc.2016.08.002 1109-9666/ª 2016 Hellenic Cardiological Society. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Please cite this article in press as: Gasparovic I, et al., Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery, Hellenic Journal of Cardiology (2016), http://dx.doi.org/ 10.1016/j.hjc.2016.08.002
+
MODEL
2
Letter to the Editor
Figure 1
differential diagnosis of coronary arteriovenous fistulae should be consider.
Conflict of interest The authors declare no conflict of interest.
References 1. Said SA, Nijhuis RL, Op den Akker JW, et al. Diagnostic and therapeutic approach of congenital solitary coronary artery fistulas in adults: Dutch case series and review of literature. Neth Heart J. 2011;19(4):183e191. 2. Kakouros NS, Kakouros SN. Clinical assessment in acute heart failure. Hellenic J Cardiol. 2015;56(4):285e301.
(continued).
Ivo Gasparovic, MD Panagiotis Artemiou, MD, PhD * Vladan Hudec, MD Michal Hulman, MD, PhD Medical Faculty of the Slovak Health University, National Institute for Cardiovascular Diseases, Clinic of Cardiac Surgery, Bratislava, Slovakia *Corresponding author. Dr Panagiotis Artemiou, National Institute of Cardiovascular Diseases, Pod krasnou horkou 1, 83101, Bratislava, Slovakia. Tel.: þ421 917 665774; fax: þ421 259 320287. E-mail address: [email protected] (P. Artemiou) 22 June 2016
Please cite this article in press as: Gasparovic I, et al., Recurrence of coronary arteriovenous fistulae in a rare case of bilateral right coronary and circumflex artery arteriovenous fistulae to the pulmonary artery, Hellenic Journal of Cardiology (2016), http://dx.doi.org/ 10.1016/j.hjc.2016.08.002