Korean Circ J.  2011 Apr;41(4):213-216. 10.4070/kcj.2011.41.4.213.

Dual Fistulas of Ascending Aorta and Coronary Artery to Pulmonary Artery

• Kim MJ
• Kwon HY
• Hwang CS
• Kang JH
• Kim HJ
• Kim SM
• Lee HG
• Kim TI
• Cho KI

• KMID: 2028947
• DOI: http://doi.org/10.4070/kcj.2011.41.4.213

Abstract

Coronary artery fistula to pulmonary artery is common. However, to the best of our knowledge, a case of coronary artery fistula to pulmonary artery associated with aortopulmonary fistula remains unreported. We herein report a 64-year-old female with a left anterior descending coronary artery and ascending aorta to pulmonary artery fistulas, and conduct a brief review of the literature.

Keyword

Coronary arteries; Echocardiography; Fistula

MeSH Terms

Aorta
Arterio-Arterial Fistula
Coronary Vessels
Echocardiography
Female
Fistula
Humans
Middle Aged
Pulmonary Artery
Arterio-Arterial Fistula
Pulmonary Artery

Figure

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  Fig. 1 Transthoracic echocardiography Doppler revealed two focal diastolic flows within the pulmonary trunk (A). In addition, a dilated left coronary artery (B), and continuous turbulent systolic and diastolic flow pattern (C) was noted.

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  Fig. 2 Coronary angiography showing normal right coronary artery (A). An aneurysm, originating from the ascending aorta and blood flow to the pulmonary artery via the fistula (B). Second coronary artery fistula originating from the left anterior descending artery with drainage into the pulmonary artery (C and D). *Aneurysm of fistula tract between the ascending aorta and pulmonary artery, open arrow head: fistula tract between the ascending aorta and pulmonary artery, arrow head: opening of aortopulmonary fistula in the ascending aorta, arrow: left main coronary artery, open arrow: fistula connection between left anterior descending coronary artery and pulmonary artery, curved arrow: tip of the diagnostic catheter.

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  Fig. 3 Multi-detector-row computed tomography showed that the fistulas were composed of two source vessels, and a single draining vessel. Two fistulas, one branching from ascending aorta (A) and another one from the left anterior descending coronary artery (B), have large aneurysm and were connected to the pulmonary trunk (C and D). *Aneurysm of fistula tract between ascending aorta and pulmonary artery, open arrow head: fistula tract between the ascending aorta and pulmonary artery, arrow head: opening of the aortopulmonary fistula in the ascending aorta, arrow: left main coronary artery, open arrow: fistula connection between the left anterior descending coronary artery and pulmonary artery.

Reference

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