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Coronary Artery to Right Atrium Fistula Associated With First Degree Atrioventricular Block: A Rare Association.

Wong RC, Teo SG, Yip JW - ASEAN Heart J (2013)

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, Singapore, China.

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Transthoracic echocardiogram (Figure 1) showed a dilated right coronary artery that was enlarged, forming multiple saccular aneurysms distally that drain into the roof of right atrium... CT angiogram (Figure 2) later confirmed the presence of a coronary artery fistula from the right coronary artery draining into the right atrium... He declined cardiac catheterization, and was advised for corrective surgery... This case illustrated a rare saccular aneurysm formation in a right coronary artery to right atrium (coronary-cameral) fistula associated with 1 degree atrioventricular (AV) block... Coronary arteriovenous fistula (CAVF) arises as a persistence of sinusoidal connections between the lumens of the primitive tubular heart in the early embryologic period... Most fistulae originate from the right coronary artery (60%) and terminate in the right side of the heart such the right ventricle or atrium, coronary sinus, and pulmonary vasculature... Hence, all CAVF ought to be closed except for trivial ones... The evolution of 1 degree AV block in our case may reflect a flow limitation to atrioventricular (AV) node directly caused by the CAVF... CT angiogram has now emerged as an excellent imaging technique to delineate the lesion anatomy CAVF generally requires closure... Transcatheter embolization techniques using coils, bags, or other devices can be performed successfully and safely, and are now the treatment modality of choice... CAVFs with multiple connections, circuitous routes, and acute angulations may however be better treated surgically.

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Related in: MedlinePlus

Transthoracic echocardiogram performed showed the tubular structure coming off the right coronary cusp (bold arrow, image A); saccular formations adjacent to the aortic root in short axis and apical 4 chamber view (bold arrows, image B and C); as well as predominantly diastolic turbulent flow within the saccular formations (image D).
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Fig1: Transthoracic echocardiogram performed showed the tubular structure coming off the right coronary cusp (bold arrow, image A); saccular formations adjacent to the aortic root in short axis and apical 4 chamber view (bold arrows, image B and C); as well as predominantly diastolic turbulent flow within the saccular formations (image D).

Mentions: Transthoracic echocardiogram (Figure 1) showed a dilated right coronary artery that was enlarged, forming multiple saccular aneurysms distally that drain into the roof of right atrium. The right heart was normal in size and function. CT angiogram (Figure 2) later confirmed the presence of a coronary artery fistula from the right coronary artery draining into the right atrium. Right coronary artery is dilated and the distal segment of the RCA is tortuous and aneurismal. Nuclear myocardial perfusion imaging showed no inducible ischemia during exercise stress. He declined cardiac catheterization, and was advised for corrective surgery.


Coronary Artery to Right Atrium Fistula Associated With First Degree Atrioventricular Block: A Rare Association.

Wong RC, Teo SG, Yip JW - ASEAN Heart J (2013)

Transthoracic echocardiogram performed showed the tubular structure coming off the right coronary cusp (bold arrow, image A); saccular formations adjacent to the aortic root in short axis and apical 4 chamber view (bold arrows, image B and C); as well as predominantly diastolic turbulent flow within the saccular formations (image D).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4544472&req=5

Fig1: Transthoracic echocardiogram performed showed the tubular structure coming off the right coronary cusp (bold arrow, image A); saccular formations adjacent to the aortic root in short axis and apical 4 chamber view (bold arrows, image B and C); as well as predominantly diastolic turbulent flow within the saccular formations (image D).
Mentions: Transthoracic echocardiogram (Figure 1) showed a dilated right coronary artery that was enlarged, forming multiple saccular aneurysms distally that drain into the roof of right atrium. The right heart was normal in size and function. CT angiogram (Figure 2) later confirmed the presence of a coronary artery fistula from the right coronary artery draining into the right atrium. Right coronary artery is dilated and the distal segment of the RCA is tortuous and aneurismal. Nuclear myocardial perfusion imaging showed no inducible ischemia during exercise stress. He declined cardiac catheterization, and was advised for corrective surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, Singapore, China.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Transthoracic echocardiogram (Figure 1) showed a dilated right coronary artery that was enlarged, forming multiple saccular aneurysms distally that drain into the roof of right atrium... CT angiogram (Figure 2) later confirmed the presence of a coronary artery fistula from the right coronary artery draining into the right atrium... He declined cardiac catheterization, and was advised for corrective surgery... This case illustrated a rare saccular aneurysm formation in a right coronary artery to right atrium (coronary-cameral) fistula associated with 1 degree atrioventricular (AV) block... Coronary arteriovenous fistula (CAVF) arises as a persistence of sinusoidal connections between the lumens of the primitive tubular heart in the early embryologic period... Most fistulae originate from the right coronary artery (60%) and terminate in the right side of the heart such the right ventricle or atrium, coronary sinus, and pulmonary vasculature... Hence, all CAVF ought to be closed except for trivial ones... The evolution of 1 degree AV block in our case may reflect a flow limitation to atrioventricular (AV) node directly caused by the CAVF... CT angiogram has now emerged as an excellent imaging technique to delineate the lesion anatomy CAVF generally requires closure... Transcatheter embolization techniques using coils, bags, or other devices can be performed successfully and safely, and are now the treatment modality of choice... CAVFs with multiple connections, circuitous routes, and acute angulations may however be better treated surgically.

No MeSH data available.


Related in: MedlinePlus