Association of atretic left internal mammary graft with internal mammary to pulmonary vasculature fistula: a case series.
Left internal mammary artery (LIMA) graft to pulmonary vasculature (PV) fistula is a rare complication of coronary artery bypass surgery (CABG), with only a handful of cases being reported. The fistula in these cases connects to a distal branch of the pulmonary artery. The etiology of these fistulae is uncertain, but is thought to be related to post surgical injury and inflammation leading to adhesions and neorevascularization. The association of an atretic LIMA with these fistulae has not been previously reported. We report six cases of LIMA to PV fistulae that were identified on coronary angiography. All six cases were associated with an atretic LIMA graft. All fistulae were small and did not appear to have significant hemodynamic or clinical consequences. This report describes a previously undescribed association of atretic LIMA graft with small LIMA to PV fistula and discusses possible mechanisms for this association.
University of Kansas Medical Center, Kansas City, KS 66160, USA.
Rachel
R
Pase-Sosland
Sameh
S
Gadallah
Kamal
K
Gupta
D000368:Aged; D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging* / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D011651:Pulmonary Artery; D011859:Radiography; D016896:Treatment Outcome