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At least 19 recordsLinked to original sources
PubMed1982

[Pulsed Doppler echocardiography in a case of coronary artery-pulmonary artery fistula: analysis of flow pattern within the main pulmonary artery and detection of a small shunt].

Flow pattern within the main pulmonary artery was analysed by pulsed Doppler echocardiography in a case of coronary artery-pulmonary artery fistula. An asymptomatic 32-year-old female was referred to our hospital for evaluation of a continuous murmur in the second interspace at the left sternal border. Other physical findings, chest roentgenograms and electrocardiograms were normal. Two-dimensional echocardiography did not play an important role in the diagnosis. However, pulsed Doppler echocardiography revealed an antegrade turbulent flow along the antero-lateral wall of the main pulmonary artery from early diastole to early systole. The direction and distribution of this abnormal flow was judged to be different from that of patent ductus arteriosus. Coronary arteriography showed a fistula from the both coronary arteries to the proximal portion of the main pulmonary artery. However, its shunt was so small that it could not be detected by oxymetry or by hydrogen-platinum electrode method. This case suggests that Doppler method is very sensitive in shunt detection and possibly useful for non-invasive diagnosis of coronary artery-pulmonary artery fistula.

Adult↗
PubMed1980

Aberrant left pulmonary artery (pulmonary artery sling): successful repair and 24 year follow-up report.

A case of anomalous left pulmonary artery arising from the right and coursing behind the trachea and anterior to the esophagus (pulmonary artery sling) is reported. The therapy currently advocated for this disorder is ligation of the anomalous vessel and performance of a left pulmonary to main pulmonary arterial anastomosis anterior to the trachea. A median sternotomy incision allows total mobilization of the anomalous vessel, minimizes respiratory embarrassment and aids in performance of the anastomosis. In the present case, a postoperative pulmonary angiogram revealed a patent left pulmonary artery, the second reported instance of such patency. The first successful repair of pulmonary artery sling was reported by Potts and colleagues in 1954. After a 24 year follow-up period their patient has normal exercise tolerance and no perfusion to the left lung is evident on ventilation-perfusion scan.

Airway Obstruction↗
PubMed1993

Hemodynamic and nonhemodynamic mechanism of experimental pulmonary edema in rats and the effect of anisodamine and tetramethylpyrazine--electron microscopic observation and measurement of pulmonary arterial, pulmonary arterial wedge and systemic arterial pressure (Part 2).

The pulmonary edema (PE) induced by adrenaline (AD) administration is similar to neurogenic PE. Anisodamine (ADM, 654-2, 30 mg/kg) and tetramethylpyrazine (TMP, 120 mg/kg) have shown significant preventive effects. Electron microscopic observation was carried out to study the changes of microvascular permeability, and the dynamic change of mean pulmonary arterial pressure (PAP, 40 rats), mean pulmonary arterial wedge pressure (PAWP, 20 rats) and mean carotid arterial pressure (CAP) were also measured. The results suggested that both ADM and TMP have significant inhibitory effects on PAWP and CAP increase, as well as on the damage responsible for the increase of microvascular and alveolar permeability.

Adrenergic alpha-Agonists↗
PubMed1999

[Surgical treatment of a ruptured saccular aneurysm associated with bilateral coronary arteries-pulmonary artery fistulas: a case report].

We reported a successful operative case of ruptured coronary artery saccular aneurysm associated with bilateral coronary arteries-pulmonary artery fistulas. A 57-year-old woman, had been treated with hemodialysis due to chronic renal failure, suffered from acute heart failure with chest pain suddenly. Echocardiograph showed moderate pericardial effusion. A saccular coronary artery aneurysm with bilateral coronary arteries-pulmonary artery fistulas revealed by coronary angiogram. Ligation of coronary artery fistula, closure of orifice of draining artery to pulmonary artery and aneurysmorrhaphy were performed emergently. Post operative angiogram revealed complete disappearance of the fistulas.

Arterio-Arterial Fistula↗
PubMed1993

[Surgical treatment of coronary artery-pulmonary artery fistula].

We experienced 4 cases of left coronary artery-pulmonary artery fistula. Two cases had small fistulas associated with atherosclerotic coronary lesions, and the other 2 had large fistulas with aneurysmal enlargement. In the former 2 cases, ligation of the fistulas and closure of the opening of fistula into the pulmonary artery through pulmonary arteriotomy were performed together with coronary artery bypass grafting and left ventricular aneurysmectomy. In one of the latter 2 cases, the fistula arising from the anterior descending branch was ligated and the opening of fistula draining into the pulmonary artery was closed through pulmonary arteriotomy. In another case, both openings of the fistula into the anterior descending branch and the pulmonary artery were closed from inside through incision of the dilated fistula. In all 4 cases, operations were performed using cardiopulmonary bypass and retrograde coronary perfusion, which could afford good heart protection even in cases with coronary lesions and coronary steal phenomenon. All cases went an uneventful postoperative course. Postoperative angiograms showed disappearance of the fistulas in 3 cases. In one case, however, residual fistula was found because a fine fistula might be overlooked. In such a case with complicated fistulas with aneurysmal enlargement, fistulas should be examined carefully through incision of the enlarged anomalous vessels. In this paper, diagnosis, operative indication and treatment for coronary artery-pulmonary artery fistula were discussed.

Adult↗
PubMed1977

Systemic artery--pulmonary artery communication in Takayasu's arteritis.

Four cases of Takayasu's arteritis in which systemic artery-pulmonary artery communication is demonstrated on thoracic aortography are presented. Pulmonary arterial involvement in Takayasu's arteritis seems to be more frequent than generally appreciated (12% in the present series). Demonstration of the communication in the absence of evidence of other causes of a shunt is strongly suggestive of pulmonary artery involvement. It is not necessary to perform pulmonary angiography to confirm the involvement unless clinically indicated. It is also stressed that the presence of pulmonary artery involvement is useful to differentiate Takayasy's arteritis from arteriosclerosis.

Adult↗
PubMed1984

Two-dimensional and pulsed Doppler echocardiographic abnormalities in coronary artery-pulmonary artery fistula.

We describe two patients who presented with precordial continuous murmurs which were diagnosed clinically as due to patent ductus arteriosus; however, two-dimensional echocardiographic and pulsed Doppler echocardiographic studies showed dilatation of the left main coronary artery with turbulent flow during systole in the lumen in both patients. Subsequent selective coronary angiographic studies showed bilateral coronary artery-pulmonary artery fistula in one patient and left coronary artery-pulmonary artery fistula in the other. This study illustrates that in a patient presenting with a continuous murmur which is suggestive of patent ductus arteriosus, such two-dimensional and pulsed Doppler echocardiographic findings as were seen in our patients should immediately alert the physician that he may be dealing with a case of coronary arterial fistula.

Coronary Vessels↗
PubMed2001

[Surgical treatment of coronary artery-pulmonary artery fistula with coronary aneurysm].

We experienced 4 cases of coronary artery-pulmonary artery fistula with coronary aneurysm, three patients had symptoms of chest pain, and 1 patient had cardiac murmur. Coronary arteriography showed that three patients had fistulas from the left coronary artery to the pulmonary artery; and that 1 patient had a fistula from both the right and left coronary arteries to the pulmonary artery. Moreover, 1 patient had 90% diameter stenosis of segment 7. The maximum diameter of the coronary aneurysm ranged from 12 to 20 mm (average: 15.3 mm). One patient underwent closure of the opening of the fistula, 2 patients underwent multiple ligatures of fistulas, and 1 patient underwent multiple ligatures of fistulas with coronary artery bypass grafting. The postoperative course of every patient was uneventful. There have been 42 reports on this abnormality in Japan. We should treat the fistula as early as possible to prevent cardiac complications such as myocardial ischemia and rupture of coronary aneurysm.

Adult↗
PubMed2001

Aneurysmal change in an internal mammary artery-pulmonary artery fistula.

We treated a rare case of aneurysm of the internal mammary artery-pulmonary artery fistula in a 32-year-old woman with unrepaired pulmonary atresia and ventricular septal defect. This aneurysm communicated with the pulmonary artery system through an aortopulmonary collateral. Aneurysmectomy was successful.

Adult↗
PubMed1989

[A successful surgical treatment of left coronary artery-pulmonary artery fistula with giant saccular aneurysm].

A surgical case of left coronary artery-pulmonary artery fistula with giant saccular aneurysm was reported. The aneurysm was successfully resected under total extra-corporeal circulation. The patient was 67-year-old female who was admitted for evaluation of chest pain and heart murmur. On coronary angiography, the diagnosis was made as a coronary artery fistula originating from the left anterior descending artery and draining into the pulmonary artery. The operation was indicated by the fact that the combination with giant saccular aneurysm and positive findings of ischemic changes on exercise electrocardiogram. Intraoperative flowmetry on the fistula revealed that estimated average flow was 200 ml/min and the coronary steal phenomenon was strongly suggested. We concluded that surgical treatment for coronary fistula with giant aneurysm can be done with minimal risk.

Aged↗
PubMed1995

Coronary artery-pulmonary artery fistula in pulmonary atresia with ventricular septal defect.

This paper reports two patients presenting a combination of coronary artery-pulmonary artery fistula and pulmonary atresia with ventricular septal defect. A confluent central pulmonary artery arose from the proximal portion of the left coronary artery in both patients. The fistulous segment between the coronary artery and the central pulmonary artery was large, and no coronary arterial stenosis was found in either patient. Besides this fistulous origin of the pulmonary blood supply, large collateral vessels originated from the descending aorta in both patients. Neither patient has shown findings of myocardial ischemia, at least in consecutive rest and exercise electrocardiograms. Both patients were successfully operated, at the ages of 3 and 8 years, respectively. The clinical and embryological implications of this rare malformation are briefly reviewed.

Arteriovenous Fistula↗
PubMed2006

A surgical case of symptomatic coronary artery-pulmonary artery fistula.

We describe a 55-year-old female patient with multiple plexiform coronary artery-pulmonary artery fistulas, who presented with ischemic episodes accompanying an inversion of T wave on an electrocardiogram even though it was a small shunt size. The surgical procedure involved closure of the openings of the fistulas from inside the pulmonary trunk using cardiopulmonary bypass with additional ligations. Postoperative coronary angiogram revealed complete interruption of the coronary artery-pulmonary trunk fistulas resulting in complete resolution of the patient's chest symptoms.

Angina Pectoris↗
PubMed1998

Coronary artery-pulmonary artery fistula originating from three major coronary branches associated with exertional chest pain and tachycardia-dependent left bundle branch block.

A 49-year-old male was admitted to our hospital because of chest pain. The pain occurred simultaneously with tachycardia-dependent left bundle branch block (LBBB) during exercise-stress and atropine-stress electrocardiogram (ECG) and on 24-h ambulatory ECG monitoring. Myocardial perfusion and metabolic scintigraphy with Tl-201 and I-123 BMIPP, respectively, showed no evidence of ischemia. Coronary arteriography revealed no atherosclerotic lesions, but did show a fistula between three major coronary arteries and the main pulmonary artery. The left-to-right shunt was undetectably small. Administration of diltiazem and metoprolol suppressed LBBB by attenuating the heart rate response to exercise, and reduced the chest pain. Therefore we presume that the exertional chest pain was not caused by myocardial ischemia but by the tachycardia-dependent LBBB. Coronary artery-pulmonary artery fistula is the most common type of coronary artery fistulae found incidentally in adulthood. Involvement of three major coronary branches is, however, rare. The case is discussed with a review of the literature.

Bundle-Branch Block↗
PubMed1991

Spontaneous near disappearance of bilateral coronary artery-pulmonary artery fistulas.

Although coronary artery fistula is a relatively rare anomaly, it sometimes develops with advancing age, requiring surgical removal. We report a unique case of a patient whose bilateral coronary artery-pulmonary artery fistulas nearly disappeared in the course of four years. This case is interesting in view of recognizing one of the natural courses of this entity.

Angiography↗
PubMed1998

Acquired coronary artery-pulmonary artery connection.

We report a patient who underwent resection of a mediastinal tumor with postoperative irradiation. Cardiac catheterization fifteen years later demonstrated coronary artery-pulmonary artery fistulas from both the right and left coronary arteries. This case report raises the issue of whether external beam irradiation may have been integral in neovascularization and the development of this acquired abnormality.

Adult↗