Coronary artery fistula from the left circumflex to the coronary sinus

A 27-year-old woman, who had received mitral valve repair for mitral regurgitation resulting from infective endocarditis, was admitted for a close examination of abnormal echocardiographic findings in the left atrium. Transthoracic echocardiography showed trivial mitral regurgitation with normal left ventricular contraction and dilatation of the coronary sinus. Auscultation revealed a grade 2 continuous murmur along the left sternal border. Transesophageal echocardiography demonstrated a marked dilatation of the coronary sinus just behind the posterior wall of the left atrium and turbulent blood flow in the dilated coronary sinus. Cardiac catheterization showed no significant step-up of oxygen saturation in the right heart and normal pulmonary artery pressure. Coronary angiography revealed a markedly dilated and tortuous circumflex coronary artery connected to the coronary sinus through a fistula. A left circumflex artery with a fistulous connection to the coronary sinus is extremely rare.     

Giant torturous left circumflex artery draining to the right atrium

Coronary artery anomalies represent a diverse group of congenital disorders characterized by abnormalities of coronary arteries anatomy. We describe an extremely rare case of giant torturous left circumflex artery draining to the right atrium manifesting by palpitations and atrial fibrillation.     

Multiple feeding vessels from left circumflex artery and right coronary artery to myxoma in left atrium

A 62-year-old woman with six months history of dizziness was admitted to our hospital. A large mass in the left atrium was detected by transthoracic echocardiography. Coronary angiography showed two feeding arteries from the right coronary artery and left circumflex artery to the left atrium. Chest computed tomography, coronary computed tomographic angiography and contrast echocardiography were performed. Those showed multiple intratumoral neovascularities from surface of the mass. After those examinations, the mass was completely resected. Histopathologic examination confirmed the diagnosis of cardiac myxoma. There was no abnormal remnant mass, based on a follow-up transthoracic echocardiography.KEYWORDS : Myxoma, coronary angiography, multiple neovascularity     

Colossal left main to right atrium fistula ligation complicated by left circumflex STEMI

Congenital left main (LM) coronary artery to right atrium fistulas with progression to aneurysm development are rare. Most patients remain asymptomatic, but for those with progressive symptoms, intervention is required. However, there are potential life-threatening complications associated with surgical intervention. We present a case of an extremely rare markedly aneurysmal LM to right atrial fistula treated with surgical ligation complicated by inferolateral ST-elevation myocardial infarction several days post-operatively treated successfully using mechanical aspiration thrombectomy, a stent-retriever, balloon angioplasty, and subsequent intravascular ultrasound-guided percutaneous coronary intervention with drug-eluting stent.     

Single coronary artery: right coronary artery originating from distal left circumflex

This report describes a patient with single coronary artery, in whom the right coronary artery originated from the distal left circumflex. However, this anomaly was not of clinical significance based on atypical nature of chest pain, negative thallium exercise test and absence of coronary obstruction.     

Coronary arterio-venous fistula from left main stem to pulmonary artery

We describe a patient with coronary arteriovenous fistula discovered during routine coronary angiography for evaluation of ischaemic heart disease. Angiography revealed a rare anomaly connecting left main stem to pulmonary artery.     

Coronary fistula from left main stem to main pulmonary artery

We describe a patient with a rare coronary arteriovenous fistula connecting the left main stem to the main pulmonary artery. This rare case was discovered during routine coronary angiography for the evaluation of the patient s coronary heart disease.     

Anomalous origin of the left circumflex coronary artery from the right coronary artery and the left anterior descending artery from the right coronary sinus

We present the case of a 67-year-old female who was admitted to our institution because of anginal chest pain. Selective coronary angiography revealed separate ostial origins of the left anterior descending (LAD) artery and the right coronary artery (RCA) from the right coronary sinus (RCS). The left circumflex (LCx) coronary artery arose from the proximal RCA. The left anterior descending had an anterior free wall and the LCx had a retroaortic course. To our knowledge, this type of combination of anatomical variation of coronary circulation has not been described in the literature.     

Single left coronary artery with origin of the right coronary artery from distal circumflex

We report two very unusual cases of agenesis of the right coronary ostium with continuation of the left circumflex artery as the right coronary artery. The recognition of the anomaly in the first case lead to a better understanding of this finding in the second case, which translated into shorter procedure time, less contrast volume, and fewer catheter manipulations.     

Stenting of an anomalous left circumflex coronary artery arising from the right coronary artery

Coronary angioplasty can provide excellent means of revascularization of anomalous coronary arteries. Successful application of angioplasty to these vessels requires angiographic knowledge of their course, structure and appropriate equipment selection. Advancement of stent delivery systems in such cases requires good support with the possibility of selective cannulation and deep engagement of the guiding catheter. We report a case of stent placement in an anomalous circumflex artery arising from the right coronary artery.     

Acute myocardial infarction of the right coronary artery originating from the distal left circumflex artery

A case of acute myocardial infarction (AMI) of the distal left circumflex, near the origin of an aberrant right coronary artery is presented. Coronary stenting was successfully performed. According to several reports, this anomaly is a common site for coronary atherosclerosis, but this is the first report of AMI.     

Coronary artery fistula with left or right ventricular communication and sinus-node dysfunction

Coronary artery fistulae that communicate with the left ventricle are quite rare; those accompanied by sinus-node dysfunction are even more unusual. We report 2 cases of congenital coronary-artery-to-left-ventricle fistula with sinus-node dysfunction. In each of these patients, fistulae arose from both left and right coronary arteries. One patient had, in addition, a right coronary artery fistula that communicated with his right ventricle. Sinusnode dysfunction encountered in these 2 patients was likely caused by chronic general ischemia arising from a steal syndrome associated with the fistulae.     

左右冠状动脉肺动脉瘘一例

患者女性,39岁,主因"发现心脏杂音38年,发作性胸闷、胸痛3年,加重1个月"收入院.患者38年前查体时发现心脏杂音,诊断为"心脏病",未予诊治.     

右冠状动脉与左回旋支闭塞心肌梗死患者的临床对比分析

目的:对比分析右冠状动脉(RCA)与左回旋支(LCX)闭塞的急性下壁心肌梗死患者的心电图特征、心功能和预后。方法:90例首次急性下壁心肌梗死患者,进行常规心电图及冠状动脉造影。RCA闭塞组(RCA组)63例,LCX闭塞组(LCX组)27例,所有患者均在发病24 h内行直接冠状动脉介入术。术后2周行99mTc-MI-BI心肌灌注断层显像测定心肌梗死面积,并行心血池显像测定左室射血分数(LVEF)。观察住院期间心律失常、心力衰竭或心源性休克的发生率及病死率。结果:①RCA组下壁并右室梗死的发生率显著高于LCX组(P<0.01),而并发侧壁梗死的发生率显著低于LCX组(P<0.01)。②RCA组Ⅲst↑>Ⅱst↑及aVL st↓>Ⅰst↓的发生率也显著高于LCX组(P<0.01)。③RCA组肌酸激酶同工酶峰值及心肌梗死面积均大于LCX组(P<0.05)。④RCA组LVEF低于LCX组(P<0.05)。结论:RCA闭塞较LCX闭塞的急性下壁心肌梗死患者心肌梗死面积大,心功能和预后差。