title: Spontaneous closure of iatrogenic coronary artery fistula to left ventricle after septal myectomy for hypertrophic obstructive cardiomyopathy.
abstract: Cases of iatrogenic coronary artery fistulas draining into the left ventricle after surgical myectomy for hypertrophic obstructive cardiomyopathy have been published as sporadic reports. However, its management scheme and prognosis are not clear because of the low incidence. A 46-yr-old woman was hospitalized for evaluation of chest pain and shortness of breath for 3 months. Transthoracic echocardiographic examination showed typical hypertrophic obstructive cardiomyopathy with a peak pressure gradient of 71 mmHg across the left ventricular outflow tract. The patient underwent surgical septal myectomy. Postoperative color Doppler imaging revealed a diastolic blood flow from the interventricular septal myocardium to the left ventricular cavity, i.e. iatrogenic coronary artery fistula to the left ventricle. Ten days later, the fistula closed spontaneously which was diagnosed by transthoracic echocardiography and confirmed by coronary angiography.
authors.affiliation: Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yu Jeong
authors.initials: YJ
authors.lastname: Choi
authors.forename: Cheol Woong
authors.initials: CW
authors.lastname: You
authors.forename: Man Ki
authors.initials: MK
authors.lastname: Park
authors.forename: Joong Il
authors.initials: JI
authors.lastname: Park
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Kwon
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Heung Jae
authors.initials: HJ
authors.lastname: Lee
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000601:surgery*; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006346:Heart Septum / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology*