Obstet Gynecol Sci.  2018 Jan;61(1):161-164. 10.5468/ogs.2018.61.1.161.

Prenatal diagnosis of isolated coronary arteriovenous fistula

• Chae U
• Lee MY
• Kim H
• Won HS
• Kim KS
• Goo HW
• Ko JK
• Park JJ

• KMID: 2420166
• DOI: http://doi.org/10.5468/ogs.2018.61.1.161

Abstract

Coronary arteriovenous fistula (CAVF) is a rare condition defined as an anomalous termination of the coronary arteries. The etiology of CAVF is either congenital or acquired, and iatrogenic CAVF is most commonly caused by cardiovascular surgery or percutaneous intervention. Most of the prenatally diagnosed CAVFs were related to complex heart disease, and only few cases of an isolated CAVF have been reported to date. We successfully diagnosed an isolated CAVF by fetal echocardiography at 25.3 weeks of gestation. Accurate prenatal diagnosis resulted in the prompt decision for postnatal surgical correction, and the neonate thrived well without any complications.

Keyword

Congenital heart defects; Coronary vessel anomalies; Prenatal diagnosis

MeSH Terms

Arteriovenous Fistula*
Coronary Vessel Anomalies
Coronary Vessels
Echocardiography
Heart Defects, Congenital
Heart Diseases
Humans
Infant, Newborn
Pregnancy
Prenatal Diagnosis*

Figure

• 

  Fig. 1 The 5-chamber view of the heart at 25.3 weeks showing the fistula between the left coronary artery and coronary sinus (arrow, A). Power Doppler imaging confirming the communication between the left coronary artery and coronary sinus (B). The 4-chamber view of the heart at 29.6 weeks showing the dilated coronary sinus (arrow) with the collapsed left atrium (C). Ao, aorta; CS, coronary sinus; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle.

• 

  Fig. 2 Postnatal computed tomography showing the dilated left circumflex artery draining into the enlarged coronary sinus on the axial image (arrow, A) and the 3-dimensional volume rendering image (arrow, B). Ao, aorta; CS, coronary sinus; LAA, left atrial appendage; LCX, left circumflex coronary artery; LMA, left main coronary artery; PA, pulmonary artery.

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