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Case Reports
. 2023 Apr 10;19(1):32-37.
doi: 10.14797/mdcvj.1187. eCollection 2023.

Dual Coronary-Pulmonary Artery Fistula in a Patient with Severe Bicuspid Aortic Valve Stenosis

Rody G Bou Chaaya  1 , Yasser Sammour  1 , Samarthkumar Thakkar  1 , Ziad Jaradat  2 , William J Gill  2 , Omar Batal  2
Affiliations
Case Reports

Dual Coronary-Pulmonary Artery Fistula in a Patient with Severe Bicuspid Aortic Valve Stenosis

Rody G Bou Chaaya et al. Methodist Debakey Cardiovasc J. .

Abstract

A 62-year-old male presented to the emergency department with acute viral bronchitis and worsening of his chronic dyspnea on exertion. Incidentally, a murmur was detected on physical examination. Extensive work-up, including coronary computed tomography angiography, revealed a rare combination and potential association between severe bicuspid aortic valve stenosis and coronary-pulmonary artery fistulas.

Keywords: aortic stenosis; bicuspid aortic valve; coronary artery; fistula; pulmonary artery.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Short axis view echo of bicuspid valve with increased velocity; see also at https://youtu.be/4C2kncWIOqM
Figure 1
Echocardiogram of short axis view showing a bicuspid valve with increased velocity across the valve; see also at https://youtu.be/4C2kncWIOqM.
3D CTA of coronary artery fistula arising from LAD and joined with second fistula arising from RCA
Figure 2
A coronary computed tomography angiography 3-dimensional (3D) reconstruction showing a coronary artery fistula arising from the left anterior descending artery joining another fistula arising from the right coronary artery, both draining into the main pulmonary artery. (A) C1: left anterior descending artery; C2: left anterior descending artery fistula; C3: right coronary artery fistula; C4: right coronary artery; C5: drainage into the pulmonary artery; C6: ectasia of the ascending aorta; (B) arrow: fistula connecting to the right coronary artery; (C) arrow: fistula connecting to the left anterior descending artery; (D) 3D reconstruction of the fistula excluding the right ventricle.
CTA axial view showing course of fistula
Figure 3
A coronary computed tomography angiography axial view showing the course of the fistula.
See this image and copyright information in PMC

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