Congenital high flow coronary cameral fistula in an 81-year-old woman: management problems.
An 81-year-old woman presenting with severe congestive heart failure was found to have a congenital right coronary fistula draining into the superior vena cava. The diagnosis was suspected on transthoracic two-dimensional echo-Doppler study and confirmed with coronary angiography. Transesophageal echocardiography and magnetic resonance imaging were nondiagnostic. An attempt to close the fistula with transcatheter embolization using a detachable latex balloon was unsuccessful because of the very large size of the fistula. Follow-up showed a favorable outcome with medical therapy. Despite the advent of more recent diagnostic and therapeutic techniques, management of such large fistulae remains unresolved.
Millaire
A
A
Division of Cardiology, Hôpital Cardiologique, Centre Hospitalier Régional Universitaire, Lille, France.
Goullard
L
L
De Groote
P
P
Ducloux
G
G
D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization; D003331:Coronary Vessels; D015150:Echocardiography, Doppler; D004621:Embolization, Therapeutic; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D014683:Vena Cava, Superior