Images in cardiovascular medicine voluminous left main stem to pulmonary artery fistula: A conservative approach.
Luca BottaCiro AmodioCarlo SaviniDavide PaciniPublished in: Journal of cardiac surgery (2020)
The presence of a coronary arteriovenous fistula is almost rare in the adult population, even rare when associated with aortic valve insufficiency. Management and treatment options can vary and depend on a single patient. In our case, a large fistula with a rounded origin started from the roof of the left main stem, just attached to the wall of the aortic root, and finished with a very narrowed end in the pulmonary trunk. Due to its anatomical position and to the potential complications related to a proximal surgical closure as well as the incidental discovery in adult age (without signs or symptoms until the operation), we decided to have a conservative approach, leaving untouched the fistula. No intraoperative, perioperative, and follow-up signs of myocardial ischemia were observed.
Keyphrases
- aortic valve
- pulmonary artery
- coronary artery
- pulmonary hypertension
- aortic stenosis
- transcatheter aortic valve replacement
- aortic valve replacement
- pulmonary arterial hypertension
- transcatheter aortic valve implantation
- patients undergoing
- left ventricular
- small molecule
- coronary artery disease
- deep learning
- cardiac surgery
- case report
- heart failure
- optical coherence tomography
- human health
- machine learning
- risk assessment
- physical activity
- climate change
- single cell
- atrial fibrillation
- drug induced
- sleep quality