An iatrogenic coronary arteriovenous fistula causing a steal phenomenon: an intracoronary Doppler study.
We present the case of a 67-year-old man in whom a guidewire broke at rotablation of the right coronary artery, creating an iatrogenic aneurysmal arteriovenous fistula to the coronary sinus. Successful Doppler wire-guided fistula occlusion by percutaneous coil embolization lead to normalization of coronary blood flow and relief of the patient's symptoms. Myocardial ischemia in this patient may have been due to a steal phenomenon caused by coronary artery fistulae, as suggested by blood flow velocity data obtained before and after fistula occlusion.
Wexberg
P
P
Department of Cardiology, Clinic for Internal Medicine II, University of Vienna, Austria. pwexberg@pop3.kard.akh-wien.ac.at
Gottsauner-Wolf
M
M
Kiss
K
K
Steurer
G
G
Glogar
D
D
D000368:Aged; D001158:Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001164:Arteriovenous Fistula / Q000150:complications* / Q000473:pathology*; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D015150:Echocardiography, Doppler; D004869:Equipment Safety; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D013349:Subclavian Steal Syndrome / Q000209:etiology*