title: Left circumflex coronary-to-pulmonary artery fistula as the exclusive collateral to the occluded left anterior descending artery.
abstract: A 64 year-old male presented with a five month history of effort angina. Non-invasive studies demonstrated preserved left ventricular function and a modest stress-induced myocardial perfusion defect at the anterior wall. Coronary angiography revealed occlusion of the proximal left anterior descending coronary artery with its distal segment well supplied by collaterals branching from a left circumflex-to-main pulmonary artery fistula. The occluded left anterior descending coronary artery was recanalised by percutaneous interventions, the collaterals vanished immediately, and the patient lived free of symptoms for the following five months.
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, Department of Medicine and Department of Surgery, National Yang Ming University School of Medicine, Taipei, Taiwan.
authors.forename: H-T
authors.initials: HT
authors.lastname: Yi
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, Department of Medicine and Department of Surgery, National Yang Ming University School of Medicine, Taipei, Taiwan.
authors.forename: H-C
authors.initials: HC
authors.lastname: Lai
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan.
authors.forename: H
authors.initials: H
authors.lastname: Hsu
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, Department of Medicine and Department of Surgery, National Yang Ming University School of Medicine, Taipei, Taiwan.
authors.forename: W-L
authors.initials: WL
authors.lastname: Lee
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan; Department of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
authors.forename: K-Y
authors.initials: KY
authors.lastname: Wang
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, Department of Medicine and Department of Surgery, National Yang Ming University School of Medicine, Taipei, Taiwan.
authors.forename: M-S
authors.initials: MS
authors.lastname: Chiang
authors.affiliation: Cardiovascular Center and Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, Department of Medicine and Department of Surgery, National Yang Ming University School of Medicine, Taipei, Taiwan. Electronic address: trliu@vghtc.gov.tw.
authors.forename: T-J
authors.initials: TJ
authors.lastname: Liu
mesh_terms: D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D017023:Coronary Angiography; D003324:Coronary Artery Disease; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016277:Ventricular Function, Left
keywords: Collateral; Coronary; Fistula; Occlusion