Spontaneous Closure of Iatrogenic Coronary Artery Fistula to Left Ventricle After Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy.
10.3346/jkms.2006.21.6.1111
- Author:
Yu Jeong CHOI
1
;
Cheol Woong YOU
;
Man Ki PARK
;
Joong Il PARK
;
Sung Uk KWON
;
Sang Chol LEE
;
Heung Jae LEE
;
Seung Woo PARK
Author Information
1. Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. swpark@smc.samsung.co.kr
- Publication Type:Case Report
- Keywords:
Cardiomyopathy, Hypertrophic;
Vascular Fistula;
Postoperative Complications
- MeSH:
Vascular Fistula/diagnosis/*etiology;
Middle Aged;
*Iatrogenic Disease;
Humans;
Heart Ventricles/*abnormalities;
Heart Septum/*surgery;
Female;
Coronary Vessel Anomalies/diagnosis/*etiology;
Cardiovascular Surgical Procedures/*adverse effects;
Cardiomyopathy, Hypertrophic/complications/*surgery
- From:Journal of Korean Medical Science
2006;21(6):1111-1114
- CountryRepublic of Korea
- Language:English
-
Abstract:
Cases of iatrogenic coronary artery fistulas draining into the left ventricle after surgical myectomy for hypertrophic obstructive cardiomyopathy have been published as sporadic reports. However, its management scheme and prognosis are not clear because of the low incidence. A 46-yr-old woman was hospitalized for evaluation of chest pain and shortness of breath for 3 months. Transthoracic echocardiographic examination showed typical hypertrophic obstructive cardiomyopathy with a peak pressure gradient of 71 mmHg across the left ventricular outflow tract. The patient underwent surgical septal myectomy. Postoperative color Doppler imaging revealed a diastolic blood flow from the interventricular septal myocardium to the left ventricular cavity, i.e. iatrogenic coronary artery fistula to the left ventricle. Ten days later, the fistula closed spontaneously which was diagnosed by transthoracic echocardiography and confirmed by coronary angiography.
