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CASE REPORTS
JOURNAL ARTICLE
[Percutaneous treatment of coronary artery fistula: a tailored strategy is needed].
Giornale Italiano di Cardiologia 2018 March
Coronary artery fistula (CAF) is a rare, abnormal connection between one or more coronary arteries and a cardiac chamber, or great vessel.We describe the case of a male patient with worsening effort angina referred for coronary angiography. The examination revealed the presence of a CAF between the proximal left anterior descending (LAD) and pulmonary arteries, with mid LAD subocclusive stenosis. Ad hoc PCI with stenting was performed in the mid LAD, followed by CAF embolization with coils and plugs. Angiography and computed tomography scan at follow-up showed complete CAF occlusion, stent patency, and normal flow reserve of the LAD. CAF treatment is indicated only for large or clinically significant symptomatic fistulas. Treatment strategy, technique and device choice should be tailored on CAF anatomical characteristics. In this case, our strategy was feasible, safe and successful with favorable long-term results.
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