Spontaneous closure of iatrogenic coronary artery fistula to left ventricle after septal myectomy for hypertrophic obstructive cardiomyopathy.
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.
Choi
Yu Jeong
YJ
Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
You
Cheol Woong
CW
Park
Man Ki
MK
Park
Joong Il
JI
Kwon
Sung Uk
SU
Lee
Sang-Chol
SC
Lee
Heung Jae
HJ
Park
Seung Woo
SW
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*