title: Percutaneous closure of an iatrogenic fistula from the left ventricle to the coronary sinus.
abstract: A patient with a history of rheumatic mitral valve disease and valve replacement in childhood presented with severe, persistent dyspnea. During an electrophyisiologic procedure, she was discovered to have a fistula from the left ventricle to the coronary sinus. She had severe pulmonary hypertension and elevated filling pressures, with a significant left-to-right shunt. Percutaneous closure of the fistula was performed using two vascular plugs. Subsequently the patient's hemodynamics improved and her symptoms subsided. Here, we describe the case and review the literature.
authors.affiliation: Pauley Heart Center, Virginia Commonwealth University Medical Center Richmond, Virginia.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Gertz
authors.affiliation: Heart and Vascular Institute, Pikeville Medical Center Pikeville, Kentucky.
authors.forename: Jose-Luis E
authors.initials: JL
authors.lastname: Velazquez-Cecena
authors.affiliation: Pauley Heart Center, Virginia Commonwealth University Medical Center Richmond, Virginia.
authors.forename: John V Ian
authors.initials: JV
authors.lastname: Nixon
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation; D002932:Cineangiography; D054326:Coronary Sinus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006335:Heart Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D020127:Recovery of Function; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: closure; coronary sinus; fistula; left ventricular outflow tract; vascular plug