Sequential moderate coronary artery fistula and moderate coronary artery stenosis causing ischemia demonstrated by fractional flow reserve and relieved following percutaneous coronary intervention

Catheter Cardiovasc Interv. 2014 Feb 15;83(3):443-7. doi: 10.1002/ccd.25170. Epub 2013 Sep 30.

Abstract

Coronary artery fistulae are rare anomalous connections arising from the coronary circulation. We report a case of anterior wall myocardial ischemia caused by the combination of sequential coronary-to-pulmonary artery fistula and moderate (50-60%) stenosis of the left anterior descending coronary artery. Ischemia was demonstrated by myocardial stress perfusion imaging as well as fractional flow reserve. Percutaneous coronary intervention of the lesion resulted in resolution of ischemia.

Keywords: coronary artery fistula; coronary atherosclerosis; fractional flow reserve; myocardial ischemia.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angina, Stable / diagnosis
  • Angina, Stable / etiology
  • Angina, Stable / physiopathology
  • Angina, Stable / therapy*
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Arterio-Arterial Fistula / complications*
  • Arterio-Arterial Fistula / diagnosis
  • Arterio-Arterial Fistula / physiopathology
  • Coronary Angiography
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / physiopathology
  • Coronary Stenosis / therapy*
  • Coronary Vessel Anomalies / complications*
  • Coronary Vessel Anomalies / diagnosis
  • Coronary Vessel Anomalies / physiopathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology*
  • Drug-Eluting Stents
  • Fractional Flow Reserve, Myocardial*
  • Humans
  • Male
  • Myocardial Perfusion Imaging / methods
  • Pulmonary Artery / abnormalities
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / physiopathology*
  • Severity of Illness Index
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome