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- Title
Percutaneous, catheter-based coil embolization of coronary fistula: determination of hemodynamic relevance.
- Authors
Oldenburg O; Philipp T; Forsting M; Erbel R; Oldenburg, Olaf; Philipp, Thomas; Forsting, Michael; Erbel, Raimund
- Abstract
A 55-year-old male with angina-like chest pain and positive thallium-scintigraphy was admitted to our hospital. Cardiac catheterization was performed for suspected coronary artery disease. The coronary angiogram showed no significant epicardial stenosis, but a large coronary fistula, connecting the left anterior descending artery with the pulmonary artery. Swan-Ganz catheter measurements, intracoronary Doppler, and quantitative coronary angiography were used to determine cardiac output, coronary blood flow, and coronary-to-pulmonary artery shunt fraction. These measurements showed a hyperdynamic cardiac output of 17 L/min, a coronary blood flow of 140 mL/min in the left anterior descending coronary artery with an estimated shunt fraction of 58% into the pulmonary circulation. Percutaneous, catheter-based coil embolization was performed to occlude the fistula. After embolization of one coil, coronary angiography showed the fistula's stump only. Cardiac output (9 L/min) and coronary blood flow (48 mL/min) were almost normalized. The patient was discharged from the hospital the day after the procedure. After a 6-month follow-up, there were still no complaints, angina-like symptoms or signs of myocardial ischemia in stress tests.
- Publication
Journal of Interventional Cardiology, 2003, Vol 16, Issue 4, p343
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1034/j.1600-6143.2003.08053.x