title: Association of coronary to left ventricular microfistulae (vessels of Wearn) with atrial septal defect in an adult without cyanotic heart disease.
abstract: Vessels of Wearn are rare findings during coronary angiography in adults. They are known to be associated with forms of cyanotic congenital heart disease in infants but we are not aware of any published cases of association with non-cyanotic left to right shunts in adults. We present the case of a 69-year-old man with angiographically evident vessels of Wearn draining from the left and right coronary arteries into the left ventricle associated with an asymptomatic atrial septal defect. We postulate a developmental phase association between atrial septal maturation and closure of perfusing microchannels from the ventricular cavities to the epicardial coronary arteries on the same spectrum as that which leads to more widespread defects in infants. We also highlight a common medication side effect that might have been mistaken as a manifestation of the congenital anomalies.
authors.affiliation: Cardiology Department Care of Dr Elved Roberts, University Hospitals of Leicester, Leicester, UK.
authors.forename: Munem
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Department of Cardiology, University Hospitals of Leicester, Leicester, UK.
authors.forename: Elved Bryn
authors.initials: EB
authors.lastname: Roberts
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis; D004452:Echocardiography; D004562:Electrocardiography; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications* / Q000175:diagnosis