Abstract
Isolated congenital coronary artery fistula (ICCAF) is an exceedingly rare anomaly in which there is a direct abnormal connection between a coronary artery and other cardiac chambers or any of great vessels. The left circumflex artery (LCX) is the least common source of ICCAF. Here we reported a rare case of large ICCAF originated from the LCX in a 9-year-old boy. He presented fatigability, murmurs and NYHA class II. Echocardiography and cardiac CT revealed that an aneurysmal dilatation of the LCX along with the dilated coronary sinus entered into the right atrium (RA) through the great cardiac vein. However, it showed that the dilated LCX directly drained into the RA by coronary angiography, which was confirmed by the surgery. During the surgical procedure, the LCX fistula was identified in a 3*3 cm bulbous structure, the aneurysmal dilation of RA tissue. The end of fistula was located in the lower-middle interatrial septum, which was near the coronary sinus and above the opening of inferior vena cava (IVC). Transcardiac chamber closure with cardiopulmonary bypass (CPB) was successfully performed for the correction of the fistula. It indicated that preoperative angiography is essential to define the details of large ICCAF with...Continue Reading
References
May 1, 1979·Circulation·R R LiberthsonF H Levine
Oct 1, 1978·American Heart Journal·D T AraniF J Klocke
Sep 1, 1966·American Heart Journal·S SakakibaraH Gomi
Oct 1, 1981·Annals of Surgery·J E LoweD C Sabiston
Jun 1, 1995·Catheterization and Cardiovascular Diagnosis·M VavuranakisH Boudoulas
May 8, 2000·The Annals of Thoracic Surgery·A Dodge-KhatamiC L Backer
Sep 11, 2002·Journal of Cardiac Surgery·Hiroyuki KamiyaGo Watanabe
Dec 20, 2003·Heart and Vessels·Yuichi SatoKatsuo Kanmatsuse
Sep 1, 2006·Pediatric Cardiology·Chi-D Liang, Sheung F Ko
Mar 6, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Sahar S AbdelmoneimDavid R Holmes
Apr 2, 2008·Congenital Heart Disease·Salah A M SaidTjeerd van der Werf
Nov 12, 2013·The Annals of Thoracic Surgery·Bin HouShi-Wei Pan
Oct 7, 2014·Prenatal Diagnosis·Carli PetersRonald T Wakai
Jun 27, 2015·Pediatric Cardiology·Laure PonthierAlban-Elouen Baruteau
Nov 14, 2018·Wiener klinische Wochenschrift·Hui GanSong Zhang