title: Sequential moderate coronary artery fistula and moderate coronary artery stenosis causing ischemia demonstrated by fractional flow reserve and relieved following percutaneous coronary intervention.
abstract: Coronary artery fistulae are rare anomalous connections arising from the coronary circulation. We report a case of anterior wall myocardial ischemia caused by the combination of sequential coronary-to-pulmonary artery fistula and moderate (50-60%) stenosis of the left anterior descending coronary artery. Ischemia was demonstrated by myocardial stress perfusion imaging as well as fractional flow reserve. Percutaneous coronary intervention of the lesion resulted in resolution of ischemia.
authors.affiliation: Nashville Veteran's Administration Medical Center and Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Hollenbeck
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Salloum
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D001159:Arterio-Arterial Fistula / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D054855:Drug-Eluting Stents; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
keywords: coronary artery fistula; coronary atherosclerosis; fractional flow reserve; myocardial ischemia