[Transcatheter embolization of ascending aorto-pulmonary fistula combined with coronary arteriovenous fistula]

Abstract

We encountered a patient with a coronary arteriovenous fistula accompanied by an ascending aortopulmonary fistula, a rare malformation. The patient was a 42-year-old female complaining of exertional dyspnea and chest pain at rest. She noticed dyspnea while going up and down the stairs, and chest pain at rest at the age of about 40 years. While she was being treated for hypertension, a cardiac murmur was detected. She was admitted to our hospital for close examination. Coronary angiography (CAG) showed a coronary arteriovenous fistula that branches from the left anterior descending branch and forms an aneurysm, running to the trunk of the pulmonary artery. On March 28, 1989, ligation of the fistula was performed. Postoperative CAG demonstrated an ascending aorto-pulmonary fistula that flowed to an aneurysm adjacent to the pulmonary artery. On November 29, transcatheter embolization was performed. She was discharged 7 days after embolization without complications. She is now being treated on an outpatient basis, and the symptoms in her chest have disappeared. Transcatheter embolization used in this patient may also be applicable in the treatment for coronary arteriovenous fistulae.