Transcoronary sinus repair of a severely dilated and tortuous right coronary artery fistulized to coronary sinus complicated with tricuspid valve insufficiency

Journal of Cardiothoracic Surgery

Case Report

Aiqiang Dong¹  Xuebiao Li¹  Jianfang Qian¹  Zhonghua Shen¹ 

[1] Cardiovascular Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), No. 88 Jiefang Road, Hangzhou, Zhejiang Province, China;Center for Diagnosis and Treatment of Cardiovascular Disease, Hangzhou, Zhejiang Province, China;National Regional Center for Cardiovascular Disease, Hangzhou, China;

关键词: Coronary artery dilation;    Coronary artery fistula;    Tricuspid valve regurgitation;    Adult congenital heart disease;   

DOI  :  10.1186/s13019-022-02047-7

 received in 2021-08-12, accepted in 2022-11-27,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRight coronary artery (RCA) fistulized to the coronary sinus is rare condition in adult cardiac anomalies, and the management and operative indication are controversial.Case presentationWe describe the case of a 45-year female patient who presented with exertional dyspnea, accompanied by intermitted lower limbs and facial edema. She was diagnosed with severe tricuspid regurgitation second to a severely dilated RCA fistulized to the coronary sinus. After multidisciplinary discussion, she underwent surgery through routine medium sternotomy, the right atrium was opened under cardiopulmonary bypass. The coronary arteriovenous fistula from the distal portion of RC to a severely enlarged coronary sinus was found. Trans-coronary sinus closure of the fistula was performed with continuous stitching and a tricuspid ring annuloplasty was done. The patient recovered uneventful post operation.ConclusionAccording to current literatures, surgical treatment was adopted for this case, instead of endovascular intervention. The optimal approach for these cases should consider the heart’s anatomical characteristics. But we need to be aware of the occurrence of myocardial infarction and tricuspid regurgitation in the early and late stage after operation.

【 授权许可】

CC BY   
© The Author(s) 2022

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