Case report: Percoronary device closure of tortuous coronary artery fistula into left atrium

Shi-Bin Sun; Zhongzheng Kong; Zeeshan Farhaj; Li Hongxin

doi:10.3389/fcvm.2023.1106420

Case report: Percoronary device closure of tortuous coronary artery fistula into left atrium

Front Cardiovasc Med. 2023 Feb 14:10:1106420. doi: 10.3389/fcvm.2023.1106420. eCollection 2023.

Authors

Shi-Bin Sun¹, Zhongzheng Kong², Zeeshan Farhaj¹, Li Hongxin¹

Affiliations

¹ Department of Cardiovascular Surgery, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering Research Center for Heart Transplant and Material, Jinan, China.
² Department of Cardiovascular Surgery, Shandong Provincial Qianfoshan Hospital, Weifang Medical University, Weifang, China.

Abstract

Surgical ligation and transcatheter occlusion are the mainstream for the treatment of coronary artery fistulas (CAFs). However, these techniques applied to tortuous and aneurysmal CAF, especially those draining into left-heart, have their known drawbacks. We report, a successful percoronary device closure of such CAF, originating from left main coronary artery and draining into left atrium, through a left subaxillary minithoracotomy. Through a puncture on the distal straight course, we occluded CAF exclusively under transesophageal echocardiography guidance. Complete occlusion was achieved. It's a simple, safe, and effective alternative for tortuous, large, and aneurysmal CAFs draining into the left heart.

Keywords: coronary artery fistula; device closure; minithoracotomy; occlusion; percoronary.

Publication types

Case Reports

Grants and funding

This study was supported by Shandong Key R&D Program (2018GSF118058) and the Natural Science Foundation of Shandong Province, China (ZR2013HM063).