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European Journal of Echocardiography Advance Access published online on September 12, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jep113
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Coronary artery–pulmonary artery fistula in a heart-transplanted patient

Tom Vermeulen1,*, Steven Haine1, Bernard P. Paelinck1, Inez E. Rodrigus2, Christiaan J. Vrints1 and Viviane M. Conraads1

1 Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
2 Department of Cardiac Surgery, Antwerp University Hospital, Belgium

Received 1 May 2009; accepted after revision 20 August 2009.

* Corresponding author. Tel: +32 3 8214174; fax: +32 3 8250848. E-mail address: tom.vermeulen{at}uza.be


  Abstract

A 64-year-old-man underwent routine elective right-left heart catheterization, 1 year after cardiac transplantation for terminal ischaemic cardiomyopathy. Surprisingly, selective coronary angiography disclosed coronary–pulmonary artery fistula with three feeding vessels originating from the proximal right coronary artery, the proximal portion of the left anterior descending artery, the circumflexus artery, and the left main coronary artery, draining into the pulmonary trunk. For this particular patient, without any significant cardiac complaints or symptoms, with normal cardiac dimensions and haemodynamic findings, a conservative approach was decided on.

Keywords: Ischaemic cardiomyopathy; Heart transplantation; Coronary artery–pulmonary artery fistula


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