A Neonate of Coronary Artery Fistula from Left Circumflex to Coronary Sinus
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The patient was a neonate with a large coronary artery fistula (CAF) between the left circumflex artery and coronary sinus in whom an intractable progressive heart failure with myocardial ischemia developed within 24 h after birth. He survived the surgical intervention and is doing well. This is the first report of coronary fistula presenting with cardiogenic shock on the first day of life. Additionally, this is the fourth case of the CAF between the left circumflex artery and coronary sinus in children, and the first case in a newborn.
KeywordsCoronary artery fistula Left circumflex artery to coronary sinus Neonate
Movie clip 1 Color flow Doppler echocardiography at age 6 h revealed a large continuous flow due to a large CAF from the left circumflex artery drainage into the dilated coronary sinus, with diastolic reverse flow in aorta. Supplementary material 1 (MPG 2528 kb)
Movie clip 2 The connecting vessel between the circumflex artery and coronary sinus vein (approximately 8 mm in diameter) was dissected carefully and ligated. Supplementary material 2 (MPG 2136 kb)
Movie clip 3 At 1 year of age, an angiogram showed deformity of the sinus of Valsalva and aneurysmally dilated left main trunk artery, with normal left ventricular function. Supplementary material 3 (MPG 1030 kb)
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