Simultaneous percutaneous transluminal coronary angioplasty and transcatheter embolization of latrogenic aortocoronary vein fistula

Coronary artery bypass grafting (CABG) can be complicated by inadvertent grafting of a coronary vein. This may result in continued angina pectoris related to the unbypassed critically narrowed coronary artery^1,2 or to congestive heart failure³ secondary to a left-to-right shunt. Therapeutic recommendations have included no treatment,^4,5 surgical ligation of the iatrogenic aorto-coronary vein fistula with or without revascularization of the diseased artery,^1,2,5–7 and percutaneous embolic occlusion of the aortocoronary vein fistula.³ This report describes a patient in whom percutaneous transluminal coronary angioplasty (PTCA) of the underlying stenosed coronary artery and percutaneous embolic occlusion of the aortocoronary vein fistula was performed simultaneously.