title: Left circumflex to right atrial coronary arterio-venous fistula - role of multimodality imaging for diagnosis.
abstract: We report an interesting case presenting with progressive dyspnea and palpitations. The patient underwent multimodal imaging procedures consisting of two dimensional echocardiography, MRI, cardiac catheterization and also a three dimensional transesophageal echocardiographic reconstruction. All the investigations taken together helped us in finally arriving at accurate anatomical diagnosis of a coronary AV fistula from the left circumflex artery to the right atrium. The patient finally underwent a successful non-surgical closure using an Amplatzer device. The role of three-dimensional echocardiographic evaluation in defining the anatomy for planning the treatment is emphasized.
authors.affiliation: Senior Consultant Cardiologist, Department of Non-Invasive Cardiology, Fortis Escorts Heart Institute and Research Centre Ltd., Okhla Road, New Delhi 110025, India. Electronic address: drvinay123@indiatimes.com.
authors.forename: Vinay Kumar
authors.initials: VK
authors.lastname: Sharma
authors.affiliation: Exécutive Director and Dean, Cardiology, Fortis Escorts Heart Institute and Research Centre Ltd., Okhla Road, New Delhi 110025, India.
authors.forename: Upendra
authors.initials: U
authors.lastname: Kaul
authors.affiliation: Associate Director, Department of Non-Invasive Cardiology, Fortis Escorts Heart Institute and Research Centre Ltd., Okhla Road, New Delhi 110025, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Shrivastava
mesh_terms: D000328:Adult; D001159:Arterio-Arterial Fistula / Q000175:diagnosis* / Q000628:therapy; D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000628:therapy; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods; D006328:Cardiac Catheterization; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000628:therapy; D015150:Echocardiography, Doppler / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: 3D TEE; Coronary arterial-venous fistula; Multimodality imaging