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Case Reports
. 2020 Jun 23;22(4):166-169.
doi: 10.1016/j.jccase.2020.05.017. eCollection 2020 Oct.

Percutaneous closure of large pulmonary artery to left atrial fistula

Anil Kumar Singhi  1 , Rana Rathod Roy  2 , Arnab De  2 , Ezaj Ahmad Bari  3 , Raman Krishna Kumar  4
Affiliations
Case Reports

Percutaneous closure of large pulmonary artery to left atrial fistula

Anil Kumar Singhi et al. J Cardiol Cases. .

Abstract

Pulmonary artery to the left atrial fistula is a rare anomaly. Two young males presented with effort intolerance and cyanosis and had large pulmonary artery to left atrial fistula from right and left pulmonary artery, respectively. The right-sided fistula was closed with a large duct occluder device in transseptal approach whereas the left-sided fistula was closed with a large muscular ventricular septal device. Complete occlusion and symptomatic relief was achieved in both cases. In the follow up the patients were doing well.

Keywords: Cyanosis; Device closure; Fistula; Left atrium; Pulmonary artery.

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Figures

Fig. 1
Fig. 1
(a) Chest X-ray showed dilated right parahilar region (multiple arrow). Computed tomographic pulmonary artery angiogram in antero-posterior (b) and lateral view (c) showed right pulmonary artery to left atrial fistula with aneurysmal sac (arrow).
Fig. 2
Fig. 2
The angiogram in frontal (a) and lateral (b) projection showed an aneurysmally dilated right pulmonary artery to left atrial fistula with a tortuous tract. Post deployment angiogram in frontal (c) and lateral (d) view showed complete occlusion of the fistula by the duct occluder marked by a notched arrow.
Fig. 3
Fig. 3
(a) Chest X-ray in frontal view showed dextrocardia and prominent left paracardiac shadow. Computed tomographic pulmonary artery angiogram (b) and three-dimensional reconstruction (c) revealed an aneurysmal left pulmonary artery to the left atrial fistula (arrow).
Fig. 4
Fig. 4
(a) Angiogram in anteroposterior view showed an aneurysmal left pulmonary artery (LPA) to left atrial (LA) connection (arrow) with rapid runoff. (b) Post occlusion angiogram showed complete occlusion of the anomalous LPA-LA fistula with large device (notched arrow).
See this image and copyright information in PMC

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