Myocardial ischemia due to a large coronary-pulmonary fistula with plexus-like morphology.
Congenital coronary-pulmonary artery fistula is a rare anomaly. We report the case of a coronary-pulmonary artery fistula with plexus-like morphology connecting the left main stem and proximal segments of the left anterior descending and circumflex coronary arteries to the main pulmonary artery in a 69-year-old woman. It caused inducible ischemia as revealed by myocardial perfusion tetrafosmin scintigraphy (Tc-99m SPECT). To our knowledge, no case of a large plexus-like coronary-pulmonary artery fistula from the very proximal left coronary artery has been reported. Furthermore, only a few cases report scintigraphic demonstration of severe ischemia in such a coronary anomaly.
Cardiothoracic Department, Istituto Scientifico San Raffaele, 'Vita-Salute' University, Milan, Italy. Altin_p@libero.it
Altin
A
Palloshi
Gianfranco
G
Aprigliano
D000368:Aged; D001159:Arterio-Arterial Fistula / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D055414:Myocardial Perfusion Imaging; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000473:pathology