A case report of an iatrogenic coronary cameral fistula treated by retrograde percutaneous coronary intervention. Issue 3 (3rd May 2020)

• Record Type: Journal Article
• Authors: Ohayon, Paul; Matta, Anthony; Boudou, Nicolas
• Editors: Holy, Erik; Rudzínski, Piotr Nikodem; Søholm, Helle; Vamvakidou, Anastasia; Mehta, Vishal Shahil
• Is Part Of: European heart journal. Volume 4:Issue 3(2020)
• Page Start: 1
• Page End: 6
• Publication Date: 2020-05-03
• Subjects: Case report -- Coronary cameral fistula -- Percutaneous coronary interventions -- Retrograde approach; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytaa094
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Acquired coronary cameral fistula is an extremely rare condition that involves an abnormal communication between a coronary artery and a cardiac chamber. It usually occurs after chest trauma or cardiovascular interventions, such as percutaneous coronary intervention (PCI) and is associated with various outcomes, ranging from a stable status to haemodynamic instability. Acquired coronary cameral fistula frequently arises from the right coronary artery and drains generally into the right ventricle. Case summary: We report the unusual case of a 56-year-old male patient referred to an invasive cardiology centre for a suspected left anterior descending (LAD) coronary–left ventricular (LV) fistula resulting from a primary PCI for an anterior ST-elevation myocardial infarction. Here, the confirmed LAD–LV fistula was successfully treated by retrograde PCI with covered stent implantation. Clinical and angiographic outcomes were favourable at 1-month follow-up. Discussion: Coronary cameral fistula can be a severe complication of primary PCI. Various treatment strategies can be considered based on haemodynamic status and anatomical features. In the case described herein, the use of a retrograde approach led to permanent fistula closure and complete revascularization.