title: Myocardial ischemia due to a coronary-to-pulmonary artery fistula proximal to an intermediate stenosis in the left anterior descending coronary artery: percutaneous closure by means of angioplasty and stent grafting.
abstract: This case report refers to a 46-year-old patient with symptomatic stable angina and myocardial ischemia documented at 99mTc-MIBI SPECT scintigraphy. Coronary angiography revealed a coronary artery fistula (CAF) and a non-significant stenosis of the left anterior descending coronary artery (LAD). We performed coronary angioplasty and stenting of the LAD and closure of the CAF using a covered stent. After the procedure the patient was asymptomatic and a myocardial scintigraphy, performed 6 months later, confirmed the absence of myocardial ischemia. This suggests that a CAF arising before a coronary stenosis may contribute to the genesis of myocardial ischemia, perhaps by giving rise to a steal phenomenon.
authors.affiliation: Clinical Division of Cardiology, University of Catania, Catania, Italy. argalassi@virgilio.it
authors.forename: Alfredo R
authors.initials: AR
authors.lastname: Galassi
authors.forename: Carmelo
authors.initials: C
authors.lastname: Grasso
authors.forename: Elisa
authors.initials: E
authors.lastname: Lettica
authors.forename: Carmelo
authors.initials: C
authors.lastname: Sgroi
authors.forename: Marco
authors.initials: M
authors.lastname: Cerrito
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001159:Arterio-Arterial Fistula / Q000150:complications* / Q000628:therapy; D023921:Coronary Stenosis / Q000150:complications*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D011651:Pulmonary Artery / Q000002:abnormalities*; D011859:Radiography; D015607:Stents