academic journalism

Ectatic-Fistulous Coronary Artery Lesion: A Newly Proposed Nomenclature


avatar Ioannis Karathanasis 1 , avatar Mathew Benjamin 1 , avatar Ilias A. Kouerinis 2 , * , avatar George Peskesis 2 , avatar Charilaos Kantsos 2 , avatar Grigorios Karagkiouzis 2 , avatar Georgia Sarri 2 , avatar Uday Trivedi 1

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

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

How to Cite: Karathanasis I , Benjamin M , Kouerinis I A , Peskesis G , Kantsos C , et al. Ectatic-Fistulous Coronary Artery Lesion: A Newly Proposed Nomenclature. Int Cardio Res J. 2016;10(3):e10179.


International Cardiovascular Research Journal: 10 (3); e10179
Published Online: September 15, 2016
Article Type: Case Report
Received: January 01, 2015
Revised: March 14, 2015
Accepted: April 06, 2015


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.


The full text is available in PDF.


  • 1.

    The references are available in PDF.

© 2016, Shiraz University of Medical Sciences.