title: Iatrogenic coronary arteriovenous fistula during percutaneous coronary intervention: unique insight into intra-procedural management.
abstract: We report the case of a 69-year-old man who presented with worsening exertional angina where subsequent percutaneous coronary intervention resulted in a coronary arteriovenous fistula. Attempts to occlude the fistula using a relatively conservative management approach with acute reversal of intraprocedural heparin and prolonged balloon inflation unfortunately resulted in extensive coronary artery thrombosis without immediate resolution of the arteriovenous fistula. However, follow-up at 6 months revealed resolution of the fistula. This case study emphasizes the uncommon but potentially life-threatening complications of percutaneous coronary interventions with implications not only relating to the hazards of managing iatrogenic arteriovenous fistula, but reversing intraprocedural heparin using protamine, during any coronary angiogram.
authors.affiliation: Department of Cardiology, Gosford Hospital, Gosford, New South Wales, Australia.
authors.forename: Bradley
authors.initials: B
authors.lastname: Wilsmore
authors.forename: Brendan
authors.initials: B
authors.lastname: Gunalingam
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000517:prevention & control*; D003331:Coronary Vessels / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D007430:Intraoperative Care; D008297:Male