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

Massive fistulization into the left ventricle of a transplanted heart

  • M. WallnerEmail author
  • R. Zweiker
  • R. Maier
  • D. Strunk
  • D. von  Lewinski
Case study

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


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)


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Copyright information

© Urban & Vogel 2015

Authors and Affiliations

  • M. Wallner
    • 1
    Email author
  • 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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