Coronary artery fistula from the left circumflex to the coronary sinus.
A 27-year-old woman, who had received mitral valve repair for mitral regurgitation resulting from infective endocarditis, was admitted for a close examination of abnormal echocardiographic findings in the left atrium. Transthoracic echocardiography showed trivial mitral regurgitation with normal left ventricular contraction and dilatation of the coronary sinus. Auscultation revealed a grade 2 continuous murmur along the left sternal border. Transesophageal echocardiography demonstrated a marked dilatation of the coronary sinus just behind the posterior wall of the left atrium and turbulent blood flow in the dilated coronary sinus. Cardiac catheterization showed no significant step-up of oxygen saturation in the right heart and normal pulmonary artery pressure. Coronary angiography revealed a markedly dilated and tortuous circumflex coronary artery connected to the coronary sinus through a fistula. A left circumflex artery with a fistulous connection to the coronary sinus is extremely rare.
Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
Shigeaki
S
Aoyagi
Shuji
S
Fukunaga
Kenji
K
Ishihara
Noriko
N
Egawa
Yukio
Y
Hosokawa
Eiji
E
Nakamura
D000328:Adult; D006328:Cardiac Catheterization; D003323:Coronary Aneurysm / Q000151:congenital / Q000175:diagnosis*; D017023:Coronary Angiography; D054326:Coronary Sinus / Q000000981:diagnostic imaging*; D003330:Coronary Vessel Anomalies / Q000175:diagnosis*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D016157:Vascular Fistula / Q000151:congenital / Q000175:diagnosis*