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Affiliation(s)
- Mitsutaka Nakashima
- Department of Cardiology, National Hospital Organization Okayama Medical Center, Japan
| | - Kei Yunoki
- Department of Cardiology, National Hospital Organization Okayama Medical Center, Japan
| | - Katsumasa Miyaji
- Department of Emergency Medicine, National Hospital Organization Okayama Medical Center, Japan
| | - Hiromi Matsubara
- Department of Cardiology, National Hospital Organization Okayama Medical Center, Japan
- Department of Clinical Science, National Hospital Organization Okayama Medical Center, Japan
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Challoumas D, Pericleous A, Dimitrakaki IA, Danelatos C, Dimitrakakis G. Coronary arteriovenous fistulae: a review. Int J Angiol 2014; 23:1-10. [PMID: 24940026 DOI: 10.1055/s-0033-1349162] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Coronary arteriovenous fistulae are a coronary anomaly, presenting in 0.002% of the general population. Their etiology can be congenital or acquired. We present a review of recent literature related to their epidemiology, etiology, pathophysiology, clinical presentation, diagnostic approach, and therapeutic management.
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Affiliation(s)
- Dimitris Challoumas
- School of Medicine, Cardiff University, Heath Park Campus, Cardiff, United Kingdom
| | - Agamemnon Pericleous
- School of Medicine, Cardiff University, Heath Park Campus, Cardiff, United Kingdom
| | | | | | - Georgios Dimitrakakis
- Department of Cardiothoracic Surgery, University Hospital of Wales, Cardiff, United Kingdom
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3
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Matsumura Y, Ochi Y, Baba Y, Tanioka K, Hirakawa D, Wada M, Hayashi K, Kubo T, Yamasaki N, Furuno T, Kitaoka H, Nishimori I, Sugiura T, Doi Y. Multiple coronary artery-left ventricle microfistulae. J Echocardiogr 2013; 11:34-5. [PMID: 27278434 DOI: 10.1007/s12574-012-0154-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 10/05/2012] [Accepted: 10/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Yoshihisa Matsumura
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
| | - Yuri Ochi
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Yuichi Baba
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Katsutoshi Tanioka
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Daigo Hirakawa
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Michiko Wada
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kayo Hayashi
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Toru Kubo
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Naohito Yamasaki
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Takashi Furuno
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Hiroaki Kitaoka
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Isao Nishimori
- First Department of Internal Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Tetsuro Sugiura
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yoshinori Doi
- Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
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Cardiac imaging in a symptomatic patient with multiple coronary artery-left ventricular microfistulae. Heart Vessels 2007; 22:428-31. [PMID: 18044003 DOI: 10.1007/s00380-007-0992-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2006] [Accepted: 04/27/2007] [Indexed: 02/07/2023]
Abstract
We present the case of a 44-year-old woman with acute coronary syndrome and multiple coronary artery-left ventricular microfistulae at angiography. To evaluate the clinical significance of this observation and to obtain further insights into this rare disease, the patient was further examined with echocardiography and both magnetic resonance imaging and single-photon emission computed tomography, which showed considerable abnormalities.
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Itoi T, Satou H, Hamaoka K. Coronary flow characteristics of multiple coronary artery-left ventricular microfistulae in young monozygotic twins. Circ J 2007; 71:1492-5. [PMID: 17721035 DOI: 10.1253/circj.71.1492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Coronary artery multiple fistulae of the left ventricular chamber are extremely rare congenital malformations. We report on 13-year-old monozygotic twin brothers who have identical abnormalities of coronary flow reserve as well as the same morphological findings of multiple coronary fistulae of the 3 major coronary arteries to the left ventricular chamber. The left circumflex coronary artery (LCX) had abundant fine communications with the left ventricular chamber and had a higher flow rate than the left anterior-descending coronary artery. The coronary flow reserve obtained from the LCX was lower than the normal value matched for the same age group. The increased shunt flow resulted in enlargement of the left ventricular chamber. This is the first report of coronary flow characteristics in children with multiple coronary fistulae.
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Affiliation(s)
- Toshiyuki Itoi
- Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Abstract
Coronary artery fistulae are abnormal communications between a coronary artery and a cardiac chamber or major vessel (vena cava, pulmonary veins, pulmonary artery). They are usually diagnosed by coronary arteriography. Clinical presentations are variable depending on the type of fistula, shunt volume, site of the shunt, and presence of other cardiac conditions. In this article, we review the literature regarding etiology, incidence, clinical manifestation, image studies, and management.
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Affiliation(s)
- L Luo
- Department of Internal Medicine, Coastal AHEC/University of North Carolina School of Medicine, Wilmington, North Carolina..
| | - S Kebede
- Department of Internal Medicine, Coastal AHEC/University of North Carolina School of Medicine, Wilmington, North Carolina
| | - S Wu
- Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina
| | - G A Stouffer
- Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina
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Ikeda H, Aotsuka H, Nakajima H. Multiple fistulas from the coronary arteries to the left ventricle in tricuspid atresia. Cardiol Young 2004; 14:562-4. [PMID: 15680081 DOI: 10.1017/s1047951104005165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It is rare to find multiple fistulas arising from all three coronary arteries and draining into the left ventricle. Coronary angiography revealed this anomaly in a one-year-old girl with tricuspid atresia after conversion to the Fontan circulation. To the best of our knowledge, this is the first report of such multiple fistulas in the setting of tricuspid atresia, and also the first report in childhood.
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Affiliation(s)
- Hiroyuki Ikeda
- Division of Pediatric Cardiology, Chiba Children's Hospital, Chiba, Japan.
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Komukai K, Muto M, Imai K, Hashimoto K, Iwano K, Mogi J, Shibata T, Horie T, Mochizuki S. Left coronary artery-left ventricle fistula with right coronary artery spasm. JAPANESE CIRCULATION JOURNAL 1998; 62:704-6. [PMID: 9766712 DOI: 10.1253/jcj.62.704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 72-year-old woman was admitted to our hospital for evaluation of chest pain. Coronary angiography showed a left coronary artery-left ventricle fistula. An acetylcholine provocation test induced vasoconstriction of the right but not the left coronary artery. Her chest pain was not relieved by combined therapy with isosorbide dinitrate, diltiazem and nicorandil. Because of the coronary spasm, beta-blockers could not be used. However, her chest pain was relieved after the administration of a minor tranquilizer. Thus, the patient's chest pain was unlikely to be associated with either the fistula or the coronary spasm.
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Affiliation(s)
- K Komukai
- Department of Cardiology, Saitama Cardiovascular and Respiratory Center, Japan.
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Abstract
Functional evaluation of coronary vasomotion encompasses the assessment of dynamic changes in coronary lumen, vessel wall, blood flow, intracoronary pressure and myocardial perfusion in response to specific pharmacologic stimuli. These parameters are obtained to characterize mechanisms of physiologic regulation and to evaluate pathophysiologic processes and potential therapeutic strategies, especially with regard to the development of coronary atherosclerosis. To this end, a variety of direct (invasive) and indirect (non-invasive) diagnostic tools are employed. Among the invasive methods are registration of intracoronary Doppler flow, coronary pressure measurements, quantitative coronary angiography and intravascular ultrasound. The non-invasive modalities consist of coronary Doppler echocardiography, positron emission tomography, myocardial scintigraphy and magnetic resonance imaging. Because of the different technical and physiological principles involved, these methods are complementary by providing independent access to different aspects. The combined invasive functional testing as employed in the cardiac catheterization laboratory allows for a simultaneous synopsis of high-resolution coronary imaging and direct measurement of physiologic parameters during local application of defined pharmacologically active substances. However, the demands in terms of equipment, time and operator skills are high and limit this combined invasive approach to specialized centers. Besides these research purposes, a number of functional methods has entered the clinical arena. They are employed to evaluate the hemodynamic significance of coronary lesions and to assess functional outcome of therapeutic interventions in the catheterization laboratory. The underlying principles and applications of the different methods are described and an overview of selected results is presented.
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Affiliation(s)
- M Elsner
- Medizinische Klinik IV (Kardiologie/Nephrologie), Johann-Wolfgang-Goethe-Universität Frankfurt.
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