Iacomini Ida Gustavo, Kalansky Michel A, Baptista Luciana de Pádua S, de Barros E Silva Pedro Gabriel Melo, Jamus Marcelo, Teixeira Garcia José Carlos, Furlan Valter, Ribeiro Expedito E, Ribeiro Henrique B
Samaritano Paulista Hospital, Sao Paulo, Brazil.
Heart Institute of São Paulo-InCor, Sao Paulo, Brazil.
J Cardiol Cases. 2020 Sep 11;23(1):16-19. doi: 10.1016/j.jccase.2020.08.009. eCollection 2021 Jan.
Coronary artery fistulas, although rare, should be included in the differential diagnosis of atypical chest pain, generally unveiled by cardiac catheterization or multidetector computed tomography. Such anatomical findings in conjunction with detectable ischemia and severe symptoms should prompt their closure. Transcatheter closure of fistulas is an attractive alternative to surgery, especially with the novel devices such as the interlock fibered detachable coils, which can be safely and effectively performed in a variety of circumstances, including the coronary arteries with tortuous anatomies. We present a case of atypical chest pain and large burden of ischemia in the stress scintigraphy, due to multiple coronary fistulas to the bronchial arteries successfully occluded with percutaneous interlock coils. < This report describes the feasibility and safety of multiple tortuous coronary-bronchial fistulas treated with the novel interlock fibered detachable coils, in a patient with prior thromboembolism. This is the first case report to use this device in this situation and shows that, in symptomatic patients with documented ischemia, such novel devices may help in treating coronary fistulas, even in tortuous anatomy.>.
冠状动脉瘘虽然罕见，但在非典型胸痛的鉴别诊断中应予以考虑，通常通过心脏导管检查或多排螺旋计算机断层扫描发现。这种解剖学发现，再加上可检测到的缺血和严重症状，应促使对其进行封堵。经导管封堵瘘是手术的一种有吸引力的替代方法，特别是使用新型装置，如联锁纤维可分离线圈，在各种情况下都能安全有效地进行，包括解剖结构迂曲的冠状动脉。我们报告一例非典型胸痛病例，在负荷心肌灌注显像中有大量缺血表现，原因是多条冠状动脉瘘至支气管动脉，经皮使用联锁线圈成功封堵。<本报告描述了在一名既往有血栓栓塞病史的患者中，使用新型联锁纤维可分离线圈治疗多条迂曲冠状动脉-支气管瘘的可行性和安全性。这是首次在这种情况下使用该装置的病例报告，表明在有症状且有缺血证据的患者中，这种新型装置可能有助于治疗冠状动脉瘘，即使在解剖结构迂曲的情况下也是如此。>
