Ectatic-Fistulous Coronary Artery Lesion: A Newly Proposed Nomenclature

Ioannis  Karathanasis; Mathew  Benjamin; Ilias A.  Kouerinis; George  Peskesis; Charilaos  Kantsos; Grigorios  Karagkiouzis; Georgia  Sarri; Uday  Trivedi

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Ectatic-Fistulous Coronary Artery Lesion: A Newly Proposed Nomenclature

Authors:

Ioannis Karathanasis¹,

Mathew Benjamin¹,

Ilias A. Kouerinis^2,*,

George Peskesis²,

Charilaos Kantsos²,

Grigorios Karagkiouzis²,

Georgia Sarri²,

Uday Trivedi¹

1Department of Cardiac Surgery, Brighton and Sussex University Hospitals, Brighton, United Kingdom

2Department of Cardiac Surgery, Hippokration Hospital, Athens, Greece

International Cardiovascular Research Journal:Vol. 10, issue 3; e10179

Published online:Sep 15, 2016

Article type:Case Report

Received:Jan 01, 2015

Accepted:Apr 06, 2015

How to Cite:Ioannis KarathanasisMathew BenjaminIlias A. KouerinisGeorge PeskesisCharilaos KantsosGrigorios KaragkiouzisGeorgia SarriUday Trivediet al.Ectatic-Fistulous Coronary Artery Lesion: A Newly Proposed Nomenclature.10(3):e10179.

Abstract

Congenital Coronary Artery Fistulae (CAF) originating from Right Coronary Artery (RCA) and draining into Coronary Sinus (CS) demonstrate high gradients and high flows, which result in ectasia of the entire artery. The anatomic margin between the ectatic RCA and the fistula are not clear and most cardiologists and cardiac surgeons tend to misname the entire vessel as “fistula”. We presented a 60-year-old female with multiple CAF draining into CS. The fistula originating from the RCA was huge and caused severe ectasia of the entire artery. The patient had progressive breathlessness due to high left to right shunt. Both fistulae were ligated under cardiopulmonary bypass. Our introduced term “ectatic-fistulous lesion” comes to address the confusion with nomenclature. It not only offers the theoretical advantage of precise description of the above complex pathology, but also allows the cardiac team to identify the anatomical margins between the ectasia and the fistula and, thus, to proceed to closure of the coronary fistula with safety.

Keywords

Fistula

Surgery

Nomenclature

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