title: A Case of Multiple Coronary Artery-Left Ventricular Micro Fistulae Complicated With Hepatic Arteriovenous Fistulae.
abstract: We present the first case of multiple coronary artery-left ventricular micro fistulae complicated with hepatic arteriovenous fistulae (AVF) in an adult patient. Multiple coronary artery fistulae originated from the left anterior descending coronary artery with aneurysmal change. Multiple coronary artery-left ventricular micro fistulae presented on the left ventricular wall and showed significant localized hypertrophic change. Stress and enhanced cardiac magnetic resonance imaging (CMR) revealed myocardial ischemia that could not be detected by stress Tl-201 cardiac scintigraphy, and late patchy gadolinium enhancement (LGE) in the mid-ventricular wall apex. This LGE pattern did not match the typical pattern observed in patients with apical hypertrophic cardiomyopathy. These observations may help distinguish multiple coronary artery-associated myocardial ischemia and hypertrophy from apical cardiomyopathy.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Niwa
authors.forename: Eriko
authors.initials: E
authors.lastname: Hasumi
authors.forename: Kastuhito
authors.initials: K
authors.lastname: Fujiu
authors.forename: Masae
authors.initials: M
authors.lastname: Uehara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nitta
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akazawa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
mesh_terms: D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis; D006352:Heart Ventricles; D006499:Hepatic Artery; D006503:Hepatic Veins; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000150:complications* / Q000175:diagnosis