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      Traumatic Left Anterior Descending Coronary Artery-Right Ventricle Fistula: A Case Report

      case-report

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          Abstract

          Traumatic coronary artery-cameral fistulas (TCAF) are rare and may present secondary to penetrating injuries (80%) or iatrogenic traumas. Early operative intervention remains the recommended treatment modality for accidental traumatic coronary artery fistulas. We report the case of a 17-year-old man who presented with left anterior descending coronary artery-right ventricle fistula following penetrating cardiac trauma, which was successfully repaired surgically.

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          The natural history and recommended management of patients with traumatic coronary artery fistulas.

          A. J. Lowe, David H Phillips, D. Adams … (1983)
          Traumatic coronary artery fistulas are reported less often than other complications resulting from both penetrating and blunt trauma to the heart. We describe a 50-year-old man in whom the natural history of a traumatic coronary fistula is well documented. This patient, who was referred for evaluation and treatment of complications of a traumatic coronary artery fistula resulting from a shrapnel injury 31 years before admission to the hospital, had five cardiac catheterizations prior to undergoing definitive surgical repair. During this period, he progressed from being totally asymptomatic to having disabling angina and congestive heart failure. These symptoms developed even though the patient's left-to-right shunt remained constant; moreover, the symptoms appeared to develop secondary to a "steal" of myocardial blood flow from the uninvolved coronary arterial bed through tortuous collaterals. Based on this experience and supported by published reports of 25 other patients, we recommend that nearly all patients with traumatic coronary artery fistulas be considered as candidates for elective surgical repair in order to prevent the eventual development of serious and possibly life-threatening complications. Operative repair can be accomplished safely with excellent long-term results.
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            Traumatic coronary artery fistula management.

            Camille Friesen, Jonathon Howlett, David Ross (2000)
            Traumatic coronary artery-cameral fistulas (TCAF) are uncommon sequelae of trauma that require early surgical intervention to prevent complications. The etiology of traumatic coronary artery-cameral fistulas may be classified as accidental or iatrogenic and have distinctly different courses depending on the etiology. The two operations described for definitive surgical closure of a traumatic coronary-cameral fistula are external ligation/obliteration of the fistula (with or without bypass grafting to the coronary artery distal to the fistula) and direct repair of the fistula from within the recipient chamber. The technique of fistula closure from within the recipient chamber is associated with a reduced incidence of fistula recurrence. A case report and a collective literature review are presented.
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              Traumatic left anterior descending artery-to-pulmonary artery fistula with delayed pericardial tamponade.

              Gareth Irwin, Steven J M Jones, Reubendra Jeganathan … (2007)
              Traumatic coronary artery fistulas are rare, but 80% are secondary to penetrating injuries. Although the left coronary artery is involved in 46% of cases, these are usually associated with fistulas to the right ventricle. We describe a successful repair of a traumatic fistula from the proximal left anterior descending artery to the pulmonary artery after delayed presentation.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Tehran Heart Cent
                Journal ID (iso-abbrev): J Tehran Heart Cent
                Journal ID (publisher-id): JTHC
                Title: The Journal of Tehran Heart Center
                Publisher: Tehran University of Medical Sciences
                ISSN (Print): 1735-5370
                ISSN (Electronic): 2008-2371
                Publication date (Print): Spring 2011
                Publication date Collection: 2011
                Publication date (Electronic): 31 May 2011
                Volume: 6
                Issue: 2
                Pages: 92-94
                Affiliations
                Golestan Hospital, Jondishapour University of Medical Sciences, Ahvaz, Iran.
                Author notes
                [* ] Corresponding Author: Mohammad Ali Sheikhi, Assistance Professor of Cardiac Surgery, Golestan Hospital, Jondishapour University Ahvaz Iran. Tel: +98 91 68013916. Fax: +986113743076. Email: sheikh.ma@ 123456yahoo.com .
                Article
                Publisher ID: jthc-6-92
                PMC ID: 3466876
                PubMed ID: 23074613
                SO-VID: ea0f3ebb-1f5f-4074-b2e2-c617cc911075
                Copyright © Copyright © Tehran Heart Center, Tehran University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Date received : 16 May 2009
                Date accepted : 28 October 2010
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: fistula,stab,wounds,coronary vessels
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: fistula, stab, wounds, coronary vessels

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