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Rupture of Aneurysmal Circumflex Coronary Artery Into the Left Atrium After Ligation of Its Arteriovenous Fistula
- Source :
- Circulation Journal. 71:1996-1998
- Publication Year :
- 2007
- Publisher :
- Japanese Circulation Society, 2007.
-
Abstract
- Aneurysmal circumflex coronary artery (Cx) with fistulous connection to the coronary sinus is a rare clinical entity that usually remains asymptomatic until later in life, so the ideal therapeutic strategy is poorly defined. The timing of surgical treatment for asymptomatic patients is a big issue, and whether to leave or exclude the diffuse aneurysm in addition to ligation of the fistula is controversial, considering the native myocardial circulation. Complete surgical repair, including exclusion of a diffusely aneurysmal Cx and coronary revascularization to a graftable branch in the circumflex area combined with ligation of its fistula, is quite challenging and sometimes fatal because of a broad posterolateral myocardial infarction without revascularization caused by a lack of graftable branches. A case of diffuse aneurysmal Cx, which ruptured into the left atrium after surgical ligation of its fistulous connection to the coronary sinus, is presented. Simple ligation of the fistula, leaving a gigantic aneurysmal circumflex artery, is hazardous for later rupture and should be avoided. Therapeutic strategies for this complex disorder are discussed, including the optimal timing of surgical treatment. (Circ J 2007; 71: 1996 - 1998)
- Subjects :
- Male
medicine.medical_specialty
Fistula
medicine.medical_treatment
Arteriovenous fistula
Aneurysm, Ruptured
Revascularization
Aneurysm
Internal medicine
medicine
Humans
Heart Atria
cardiovascular diseases
Myocardial infarction
Circumflex
Ligation
Coronary sinus
business.industry
Cardiovascular Surgical Procedures
Coronary Aneurysm
Coronary Sinus
General Medicine
Middle Aged
medicine.disease
Coronary Vessels
Surgery
Arteriovenous Fistula
cardiovascular system
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 13474820 and 13469843
- Volume :
- 71
- Database :
- OpenAIRE
- Journal :
- Circulation Journal
- Accession number :
- edsair.doi.dedup.....931f14e9ad18ae12da77b36a21f01feb