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Herz

, Volume 40, Supplement 1, pp 56–58 | Cite as

Massive fistulization into the left ventricle of a transplanted heart

  • M. Wallner
  • R. Zweiker
  • R. Maier
  • D. Strunk
  • D. von  Lewinski
Case study
  • 78 Downloads

Coronary artery fistulas are rare abnormalities of the coronary arteries with an incidence of 0.08–0.3 % [1]. After orthotopic cardiac transplantation the incidence increases to approximately 8 %, which is very likely related to repeated endomyocardial biopsies usually taken from the right ventricular portion of the interventricular septum [2]. Fistulas can occur in any of the three major coronary arteries. Most of these fistulas are related to the right coronary artery (RCA) or the left anterior descending artery (LADA); however, the circumflex coronary artery (CX) is also affected infrequently (RCA in approximately 55 % of cases, LCA in 35 %, and both in 5 %) [3]. More than 90 % of coronary artery fistulas drain into the low-pressure venous system resulting in a left-to-right shunt. Fistula drainage occurs into the left ventricle [4] in only 3 % of cases. Most fistulas present single communications; nevertheless, multiple fistulization has been described. Fistulas are usually of...

Ausgeprägte koronare Fistelbildung im linken Ventrikel nach Herztransplantation

Notes

Compliance with ethical guidelines

Conflict of interest. M. Wallner, R. Zweiker, R. Maier, D. Strunk, and D. von Lewinski state that there are no conflicts of interest. The accompanying manuscript does not include studies on humans or animals.

Supplementary material

59_2014_4077_MO1_ESM.avi (6.3 mb)
Video 1: angiographic view, massive coronary-cameral fistulization between LAD and left ventricle (AVI 6 MB)
59_2014_4077_MO2_ESM.avi (6.8 mb)
Video 2: angiographic view, coronary-cameral fistulization between RCA and left ventricle (AVI 7 MB)

References

  1. 1.
    Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 21:28–40CrossRefPubMedGoogle Scholar
  2. 2.
    Wang LW, Baron DW, Wynne DG et al (2012) Coronary-cameral and coronary arteriovenous fistulae in a transplanted heart. Circulation 126:2018–2019CrossRefPubMedGoogle Scholar
  3. 3.
    Umana E, Massey CV, Painter JA (2002) Myocardial ischemia secondary to a large coronary-pulmonary fistula–a case report. Angiology 53:353–357CrossRefPubMedGoogle Scholar
  4. 4.
    Levin DC, Fellows KE, Abrams HL (1978) Hemodynamically significant primary anomalies of the coronary arteries. Angiographic aspects. Circulation 58:25–34CrossRefPubMedGoogle Scholar
  5. 5.
    Farooki ZQ, Nowlen T, Hakimi M, Pinsky WW (1993) Congenital coronary artery fistulae: a review of 18 cases with special emphasis on spontaneous closure. Pediatr Cardiol 14:208–213CrossRefPubMedGoogle Scholar
  6. 6.
    Stierle U, Giannitsis E, Sheikhzadeh A, Potratz J (1998) Myocardial ischemia in generalized coronary artery-left ventricular microfistulae. Int J Cardiol 63:47–52CrossRefPubMedGoogle Scholar
  7. 7.
    Labler L, Rancan M, Mica L et al (2009) Vacuum-assisted closure therapy increases local interleukin-8 and vascular endothelial growth factor levels in traumatic wounds. J Trauma 66:749–757CrossRefPubMedGoogle Scholar
  8. 8.
    Zhou M, Yu A, Wu G et al (2013) Role of different negative pressure values in the process of infected wounds treated by vacuum-assisted closure: an experimental study. Int Wound J 10:508–515CrossRefPubMedGoogle Scholar

Copyright information

© Urban & Vogel 2015

Authors and Affiliations

  • M. Wallner
    • 1
  • R. Zweiker
    • 1
  • R. Maier
    • 1
  • D. Strunk
    • 2
  • D. von  Lewinski
    • 1
  1. 1.Division of CardiologyMedical University of GrazGrazAustria
  2. 2.Experimental & Clinical Cell Therapy InstituteSpinal Cord & Tissue Regeneration Center, Paracelsus Medizinische PrivatuniversitätSalzburgAustria

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