Conservatively Managed Iatrogenic Coronary Fistula to the Coronary Sinus During Primary Percutaneous Intervention
Year: 2025
Type: article
Study design: Case Report
Abstract: BACKGROUND: Iatrogenic coronary fistula is a rare complication during percutaneous coronary intervention. CASE SUMMARY: A 69-year-old woman presented with inferior ST-segment elevation myocardial infarction for which she underwent a primary percutaneous coronary intervention. During the procedure, a communication was noted between the distal right coronary artery and the coronary sinus. The patient was hemodynamically stable. She underwent a computed tomography coronary angiography and echocardiography which confirmed the diagnosis of coronary fistula. She underwent staged procedure for percutaneous coronary intervention, and the fistula flow diminished. The patient remained under follow-up and regular imaging assessment with no concerning signs or symptoms. DISCUSSION: Despite its rarity, iatrogenic coronary fistula during intervention can occur due to intimal balloon inflation, guidewire perforation, and artery-balloon size mismatch. TAKE-HOME MESSAGES: The appropriate treatment for iatrogenic coronary fistula should be determined on an individual-specific basis. A detailed multimodality imaging assessment is required to determine the fistula route and its hemodynamic effect.
Source: JACC Case Reports
Authors: Tarek Mahdy, Mahmoud Khedr, Edward Hoey, Gurbir Bhatia, Jerome Ment, George Pulikal
Institution: University Hospitals Birmingham NHS Foundation Trust
Language: English
Topic: Coronary Artery Anomalies
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $850
OpenAlex ID: W4417304775