Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

BMC Cardiovascular Disorders

Yida Tang¹  Lin Li¹  Shaodong Ye¹  Xuanqi An¹  Shaoxian Guo²  Huawei Dong²  Xuejing Duan³ 

[1] State Key Laboratory of Cardiovascular Disease, Center of Internal Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Rd, Xicheng District, 100037, Beijing, People’s Republic of China;State Key Laboratory of Cardiovascular Disease, Center of Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, People’s Republic of China;State Key Laboratory of Cardiovascular Disease, Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, People’s Republic of China;

关键词: Coronary artery-to-pulmonary artery fistula;    Giant coronary aneurysm;    Thrombus;    Coronary angiography;    Surgery ligation;   

DOI  :  10.1186/s12872-021-02077-4

来源: Springer

【 摘 要 】

BackgroundCoronary artery-to-pulmonary artery fistula is a rare disorder characterized by abnormal vascular communication between the coronary artery and pulmonary artery. While most patients remain asymptomatic, some might exhibit symptoms of myocardial ischemia, congestive heart failure, or even sudden cardiac death if coronary aneurysm, thrombosis, infective carditis, or other congenital cardiac defects coexist.Case presentationWe present a 66-year-old male complaining of angina pectoris with a history of hypertension and active smoking. He was diagnosed with a coronary aneurysm based on coronary computed tomography angiography. We subsequently identified a coronary artery-to-pulmonary artery fistula with giant aneurysmal dilation on coronary angiography. Ultimately we conducted surgery ligation and aneurysmorrhaphy. During surgery, we discovered newly formed thrombus within the aneurysmal cavity. Histological analysis of the aneurysmal wall supported the diagnosis of the congenital disorder. Our patient was successfully discharged and remained asymptomatic at two months of follow-up.ConclusionWe presented a rare and complex combination of congenital coronary artery-to pulmonary artery fistula, giant coronary aneurysmal dilatation, and thrombosis through multi-modality evaluations.

【 授权许可】

CC BY