Transcatheter Closure of Left Ventricle to Coronary Sinus Fistula Post-MVR and Septal Myectomy

Rory S Bricker; Robert A Quaife; Shiuh-Yung J Chen; John C Messenger; Jacob Hammers; John D Carroll

doi:10.1016/j.jaccas.2021.05.020

Transcatheter Closure of Left Ventricle to Coronary Sinus Fistula Post-MVR and Septal Myectomy

JACC Case Rep. 2021 Aug 19;3(10):1258-1263. doi: 10.1016/j.jaccas.2021.05.020. eCollection 2021 Aug 18.

Authors

Rory S Bricker¹, Robert A Quaife¹, Shiuh-Yung J Chen¹, John C Messenger¹, Jacob Hammers², John D Carroll¹

Affiliations

¹ Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
² Philips Healthcare, Andover, Massachusetts, USA.

Abstract

This paper describes the case of a patient who developed refractory heart failure due to a fistula from the left ventricle to the coronary sinus that was unintentionally created after a surgical myectomy and mitral valve replacement. Advanced image guidance with a pre-procedure 3-dimensional physical model and intraprocedure echocardiography fusion facilitated transcatheter plugging of the shunt with symptom resolution. (Level of Difficulty: Advanced.).

Keywords: AVP, Amplatzer vascular plug; CS, coronary sinus; CTA, computed tomography angiography; LV, left ventricle; MAC, mitral annular calcification; NYHA, New York Heart Association; TEE, transesophageal echocardiogram; TTE, transthoracic echocardiogram; VSD, ventricular septal defect; fistula; fusion; imaging; percutaneous; plug; structural.

Publication types

Case Reports