Percutaneous management strategies for STEMI with coexisting aneurysmal coronary- to-pulmonary artery fistula: a case report

Jennifer Frampton; Eric Rothstein; Alexander Iribarne; Richard Powell; Michael N Young

doi:10.1093/ehjcr/ytab157

Percutaneous management strategies for STEMI with coexisting aneurysmal coronary- to-pulmonary artery fistula: a case report

Eur Heart J Case Rep. 2021 May 16;5(5):ytab157. doi: 10.1093/ehjcr/ytab157. eCollection 2021 May.

Authors

Jennifer Frampton¹, Eric Rothstein¹, Alexander Iribarne², Richard Powell³, Michael N Young¹

Affiliations

¹ Section of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA.
² Section of Cardiac Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA.
³ Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA.

Abstract

Background: Coexistence of coronary artery fistulas and atherosclerotic coronary artery disease (CAD) is rare.

Case summary: We present a unique case of a patient initially presenting with an anterior ST-elevation myocardial infarction, subsequently found to have two-vessel CAD and an aneurysmal left coronary-to-right pulmonary artery fistula.

Discussion: After discussion with the patient and a multidisciplinary discussion with the heart team, consisting of cardiovascular surgery, interventional cardiology, and vascular surgery, a percutaneous approach was chosen. He underwent successful multivessel percutaneous coronary intervention followed by fistula embolization.

Keywords: Case report; Coronary artery fistula; Fistula embolization; STEMI.

Publication types

Case Reports