Korean Circ J.  2011 Feb;41(2):105-108. 10.4070/kcj.2011.41.2.105.

Iatrogenic Left Internal Mammary Artery to Great Cardiac Vein Anastomosis Treated With Coil Embolization

• Jung IS
• Jeong JO
• Kim SS
• Shin BS
• Shin SK
• Park YK
• Jin SA
• Ahn KT
• Seong IW

• KMID: 2225144
• DOI: http://doi.org/10.4070/kcj.2011.41.2.105

Abstract

Inadvertent left internal mammary artery (LIMA)-great cardiac vein (GCV) anastomosis is a rare complication of coronary artery bypass graft surgery. Patients with iatrogenic aortocoronary fistula (ACF) were usually treated surgical repair, percutaneous embolic occlusion with coil or balloon. We report a case of iatrogenic LIMA to GCV anastomosis successfully treated with coil embolization and protected left main coronary intervention through the percutaneous transfemoral approach.

Keyword

Coronary Artery Bypass Surgery; Internal Mammary-Coronary Artery Anastomosis; Arteriovenous fistula; Embolization, therapeutic

MeSH Terms

Arteriovenous Fistula
Coronary Artery Bypass
Embolization, Therapeutic
Fistula
Humans
Internal Mammary-Coronary Artery Anastomosis
Mammary Arteries
Transplants
Veins

Figure

• 

  Fig. 1 Volume rendering images (A and B) and axial view (C and D) of coronary CT angiography showed inadvertent left internal mammary artery to great cardiac vein anastmosis (white arrow). LIMA: left internal mammary artery graft, GCV: great cardiac vein.

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  Fig. 2 Left internal mammary artery angiography showing the left internal mammary artery anastomsed to the great cardiac vein, with contrast filling and dilated coronary sinus emptying into right atrium. LIMA: Left internal mammary artery graft, GCV: great cardiac vein.

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  Fig. 3 A: left internal mammary artery angiography showed guide wire in LIMA and GCV. B: iatrogenic LIMA-GCV fistula was occluded using 3 coils (black arrows). There was no residual shunt flow in the iatrogenic LIMA-GCV fistula after coil embolization B. LIMA: left internal mammary artery graft, GCV: great cardiac vein.

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