Case Report: "Dumbbell" giant right coronary artery ectasia with right atrial fistula

被引：0

作者：

Shan, Jianggui ^{[1
]}

Wang, Heng ^{[1
]}

Xue, Song ^{[1
]}

机构：

[1] Shanghai Jiao Tong Univ, Affiliated Renji Hosp, Sch Med, Dept Cardiovasc Surg, Shanghai, Peoples R China

来源：

FRONTIERS IN CARDIOVASCULAR MEDICINE | 2025年 / 12卷

关键词：

cardiovascular surgery; case report; computed tomography angiography; coronary artery ectasia; coronary artery fistula;

D O I：

10.3389/fcvm.2025.1498359

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 50-year-old female patient presented with a "dumbbell" giant right coronary artery ectasia, characterized by two artery dilation segments both reaching the level of a giant aneurysm with a normal segment between them. Computed tomography angiography showed a fistula sac in the right atrium. The vessel shape was a typical type IV (localized or segmental) coronary artery ectasia, which is rarely seen on true imaging. The patient had a 3-year history of chest tightness, without dyspnea, worsened by physical activity. Additional tests indicated that she had mitral valve regurgitation, superficial myocardial bridge, and anemia, all of which led to the development of her symptoms. She felt relieved after successful coronary artery fistula repair, mitral valvuloplasty, and fistula sac removal. At the 6-month follow-up, no complications were found according to echocardiography. Patients with coronary aneurysms can be asymptomatic in the early stage, while this case indicates that the dumbbell shape may be a developing stage of giant coronary aneurysm whose origin and close-fistula segments are influenced by separate hydrodynamics during ectasia or aneurysm formation.

引用

页数：6

共 11 条

[1]

Buccheri D., Chirco P., Geraci S., Caramanno G., Cortese B., Coronary artery fistulae: anatomy, diagnosis and management strategies, Heart Lung Circ, 27, pp. 940-951, (2018)

[2]

Devabhaktuni S., Mercedes A., Diep J., Ahsan C., Coronary artery ectasia-a review of current literature, Curr Cardiol Rev, 12, pp. 318-323, (2016)

[3]

Kawsara A., Nunez Gil I., Alqahtani F., Moreland J., Rihal C., Alkhouli M., Management of coronary artery aneurysms, JACC Cardiovasc Interv, 11, pp. 1211-1223, (2018)

[4]

Kloeser R., Buser A., Bolliger D., Treatment strategies in anemic patients before cardiac surgery, J Cardiothorac Vasc Anesth, 37, pp. 266-275, (2023)

[5]

Li D., Wu Q., Sun L., Song Y., Wang W., Pan S., Et al., Surgical treatment of giant coronary artery aneurysm, J Thorac Cardiovasc Surg, 130, pp. 817-821, (2005)

[6]

Cao H., Qiu Y., Yuan D., Yu J., Li D., Jiang Y., Et al., A computational fluid dynamics study pre- and post-fistula closure in a coronary artery fistula, Comput Methods Biomech Biomed Engin, 23, pp. 33-42, (2020)

[7]

Rafiei A., Saidi M., Aneurysm geometric features effect on the hemodynamic characteristics of blood flow in coronary artery: CFD simulation on ct angiography-based model, Med Biol Eng Comput, 60, pp. 3357-3375, (2022)

[8]

Khalil G., Elbadri A., Abbasi S., Das I., Ladwiniec A., An unusual cause of acute coronary syndrome: thrombosis of right coronary artery to right atrium fistula, BMJ Case Rep, 16, (2023)

[9]

Shirai K., Ogawa M., Kawaguchi H., Kawano T., Nakashima Y., Arakawa K., Acute myocardial infarction due to thrombus formation in congenital coronary artery fistula, Eur Heart J, 15, pp. 577-579, (1994)

[10]

Mangukia C., Coronary artery fistula, Ann Thorac Surg, 93, pp. 2084-2092, (2012)

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