Arteriovenous and Intercoronary Fistulae Presenting as Heart Failure in an Adult

Keywords
Heart Failure; Arteriovenous Fistula; Heart Valve Diseases/ surgery

A 79-year-old man with prior aortic valve replacement was admitted to our hospital due to exertional angina. Single-photon emission computed tomography revealed ischemia at the territory of the left anterior descending artery (LAD) and the right coronary artery (RCA) (Figures 1 AandB). Coronary arteriography (Figures 1 Cand D) and cardiac computed tomographic angiography (Figure 1 E), including volume rendering reconstruction (Figure 1 F), revealed an arteriovenous fistula between the proximal LAD and the pulmonary artery (PA). There was another fistula between the ostium of the RCA and the PA (Figures 1 G and H). This vessel gave origin to a small branch to the middle part of the LAD, before reaching the PA, thus forming a third, intercoronary fistula (Figures C, D and F).

• Sources of Funding
  There were no external funding sources for this study.
• Study Association
  This study is not associated with any thesis or dissertation work.

Publication Dates

• Publication in this collection
  Nov 2015

History

• Received
  03 May 2015
• Reviewed
  13 Mar 2015
• Accepted
  27 May 2015