Images in cardiovascular medicine voluminous left main stem to pulmonary artery fistula: A conservative approach. Issue 5 (16th March 2020)

• Record Type: Journal Article
• Authors: Botta, Luca; Amodio, Ciro; Savini, Carlo; Pacini, Davide
• Is Part Of: Journal of cardiac surgery. Volume 35:Issue 5(2020)
• Page Start: 1098
• Page End: 1099
• Publication Date: 2020-03-16
• Subjects: coronary fistula -- left main stem -- pulmonary artery; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.14483
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: The presence of a coronary arteriovenous fistula is almost rare in the adult population, even rare when associated with aortic valve insufficiency. Management and treatment options can vary and depend on a single patient. In our case, a large fistula with a rounded origin started from the roof of the left main stem, just attached to the wall of the aortic root, and finished with a very narrowed end in the pulmonary trunk. Due to its anatomical position and to the potential complications related to a proximal surgical closure as well as the incidental discovery in adult age (without signs or symptoms until the operation), we decided to have a conservative approach, leaving untouched the fistula. No intraoperative, perioperative, and follow‐up signs of myocardial ischemia were observed.