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. 2014 Apr;22(4):139-47.
doi: 10.1007/s12471-014-0518-z.

Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature

S A M Said  1 , R M Oortman, J-H Hofstra, P M J Verhorst, R H J A Slart, M W de Haan, F Eerens, H J G M Crijns
Affiliations

Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature

S A M Said et al. Neth Heart J. 2014 Apr.

Abstract

Background: Coronary bronchial artery fistulas (CBFs) are rare anomalies, which may be isolated or associated with other disorders.

Materials and methods: Two adult patients with CBFs are described and a PubMed search was performed using the keywords "coronary bronchial artery fistulas" in the period from 2008 to 2013.

Results: Twenty-seven reviewed subjects resulting in a total of 31 fistulas were collected. Asymptomatic presentation was reported in 5 subjects (19 %), chest pain (n = 17) was frequently present followed by haemoptysis (n = 7) and dyspnoea (n = 5). Concomitant disorders were bronchiectasis (44 %), diabetes (33 %) and hypertension (28 %). Multimodality and single-modality diagnostic strategies were applied in 56 % and 44 %, respectively. The origin of the CBFs was the left circumflex artery in 61 %, the right coronary artery in 36 % and the left anterior descending artery in 3 %. Management was conservative (22 %), surgical ligation (11 %), percutaneous transcatheter embolisation (30 %), awaiting lung transplantation (7 %) or not reported (30 %).

Conclusions: CBFs may remain clinically silent, or present with chest pain or haemoptysis. CBFs are commonly associated with bronchiectasis and usually require a multimodality approach to be diagnosed. Several treatment strategies are available. This report presents two adult cases with CBFs and a review of the literature.

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Figures

Fig. 1
Fig. 1
a Myocardial perfusion imaging (MPI) demonstrating the irreversible defect of the inferior segment, b Coronary angiographic frame of RCA demonstrating a CBF between a proximal branch of RCA and bronchial artery before coiling (arrow), c Normal findings on the rest 13N-ammonia polar map (left panel) and a large absolute perfusion defect (dark blue) in the inferior wall after pharmacological stress with adenosine (right panel) and d Coronary angiographic frame of RCA demonstrating disappearance of the CBF between a proximal branch of RCA and bronchial artery after coiling (arrow)
Fig. 2
Fig. 2
a Chest X-ray demonstrating bronchiectasis at the right and left lower regions of the lung (arrows), b Coronary angiographic frame of RCA in AP position, depicting the CBF between a proximal branch of the RCA and bronchial artery (arrow) and c Thoracic computed tomography scan showing the bilateral bronchiectasis
See this image and copyright information in PMC

References

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