ISSN 1016-5169 | E-ISSN 1308-4488
pdf
Percutaneous closure of a complex fistula that originates from all coronary arteries and drains to the pulmonary artery [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(8): 682-684 | DOI: 10.5543/tkda.2021.21059

Percutaneous closure of a complex fistula that originates from all coronary arteries and drains to the pulmonary artery

Ali Nazmi Çalık, Mustafa Azmi Sungur, Şükrü Akyüz
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey

A coronary-to-pulmonary-artery fistula (CPAF) is defined as a connection between the coronary arteries and the pulmonary arteries (PAs). Invasive treatment options for CPAFs include surgical ligation and transcatheter coil or plug embolization. A 60-year-old female patient was referred to our hospital with symptoms of exercise-induced angina (Canadian Cardiovascular Society Class III [CCS-3]). Her relevant history included elective stenting of the left anterior descending (LAD) artery in 2013 and surgery for an LAD to PA fistula in 2015. Upon recurrence of the same fistula in 2017, she underwent a failed antegrade (from LAD to PA) attempt for percutaneous closure of the fistula. A retrograde approach was decided because of the extensive tortuosity of the fistula’s proximal part that led to the previous failed attempt and the likelihood of ceasing whole blood flow at the fistula’s distal neck. Through right femoral venous access, we advanced a 5 Fr. 45 cm TorqVue low-profile delivery system (St. Jude Medical, Little Canada, MN, USA) over a J-tip 0.035-inch guidewire to the PA. The antegrade imaging guidance enabled us to advance the guidewire to the distal neck of the fistula retrogradely. As the distal part of the fistula was similar to a tunnel-shaped patent ductus arteriosus (PDA) and was measured 4 mm at the narrowest diameter, we opted for an Amplatzer duct occluder II 6 × 6 (Abbott Vascular, Chicago, IL, USA) to close it.

Keywords: coronary, pulmonary artery, fistula, percutaneous closure









How to cite this article
Ali Nazmi Çalık, Mustafa Azmi Sungur, Şükrü Akyüz. Percutaneous closure of a complex fistula that originates from all coronary arteries and drains to the pulmonary artery. Turk Kardiyol Dern Ars. 2021; 49(8): 682-684

Corresponding Author: Ali Nazmi Çalık, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

Quick Search



Copyright © 2024 Archives of the Turkish Society of Cardiology



Kare Publishing is a subsidiary of Kare Media.