Ponce Macayla, Manouchehri Shaya, Sumalbag Jericho, Ben-Zur Uri
Department of Cardiology, The University of La Verne, La Verne, California, USA.
Cardiovascular Institute of Greater Los Angeles, Tarzana, California, USA.
JACC Case Rep. 2025 Apr 2;30(7):103402. doi: 10.1016/j.jaccas.2025.103402.
Coronary artery fistulae (CAF) are defined as an abnormal connection between a coronary artery and another luminated vascular or nonvascular organ. Most cases are small and remain asymptomatic. Multiple fistulae involving both coronary arteries are uncommon. A 49-year-old man presented with persistent, progressive, nonexertional chest pain. Coronary computed tomography angiography revealed multiple anomalous CAF draining into a large aneurysm that connected to the pulmonary sinus. The patient underwent percutaneous coronary angiography and transcatheter coil embolization of the aneurysm with 12 coils placed. Symptomatic CAF require intervention to prevent the development of complications. The transcatheter approach is associated with a lower rate of complications and fistula recurrence compared with open-heart surgery. This case illustrates the effectiveness of transcatheter coil embolization in the treatment of coronary artery to pulmonary sinus fistulae.
冠状动脉瘘（CAF）定义为冠状动脉与另一个有腔的血管或非血管器官之间的异常连接。大多数病例瘘口较小，且无症状。累及双侧冠状动脉的多发瘘并不常见。一名49岁男性因持续性、进行性、非劳力性胸痛就诊。冠状动脉计算机断层扫描血管造影显示多发异常冠状动脉瘘引流至一个与肺窦相连的大动脉瘤。该患者接受了经皮冠状动脉造影及经导管对动脉瘤进行弹簧圈栓塞术，共置入12个弹簧圈。有症状的冠状动脉瘘需要进行干预以预防并发症的发生。与心脏直视手术相比，经导管治疗方法的并发症发生率及瘘复发率更低。本病例说明了经导管弹簧圈栓塞术治疗冠状动脉至肺窦瘘的有效性。
