Case Report: Coronary-Pulmonary Fistula Closure by Percutaneous Approach: Learning From Mistakes

Vladimir Rubimbura; Grégoire Girod; Alain Delabays; David Meier; David C Rotzinger; Olivier Muller; Salah D Qanadli; Éric Eeckhout

doi:10.3389/fcvm.2021.779716

Case Report: Coronary-Pulmonary Fistula Closure by Percutaneous Approach: Learning From Mistakes

Front Cardiovasc Med. 2022 Jan 25:8:779716. doi: 10.3389/fcvm.2021.779716. eCollection 2021.

Authors

Vladimir Rubimbura^{1

2}, Grégoire Girod^{1

3}, Alain Delabays^{1

2}, David Meier¹, David C Rotzinger^{1

4}, Olivier Muller¹, Salah D Qanadli^{1

4}, Éric Eeckhout¹

Affiliations

¹ Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland.
² Cardiology Unit, Ensemble Hospitalier de la Côte, Morges, Switzerland.
³ Cardiology Department, Sion Hospital, Sion, Switzerland.
⁴ Radiology Department, Lausanne University Hospital, Lausanne, Switzerland.

Abstract

Coronary-pulmonary artery fistulas (CPAF) are congenital vascular anomalies detected incidentally in most cases. When a significant left-right shunt exists, surgical, or percutaneous treatment is indicated. We describe a challenging case of CPAF closure, by percutaneous approach, in a patient symptomatic for dyspnea and evidence of a significant left-right shunt. A first attempt to close the fistula was performed implanting a vascular plug but it quickly embolized. The plug was successfully retrieved. In a second attempt, we deployed several coils before implanting the vascular plug with total closure of the fistula. The combination of plugs and coils is associated with a higher success rate of closure.

Keywords: congenital heart; dyspnea; fistula (coronary artery); percutaneous coronary intervention; shunt.

Publication types

Case Reports