An unusual case of infective endocarditis involving a right coronary artery to superior vena cava fistula

Ujjval Jariwala, Rani K. Hasan, Eric M. Thorn, Sammy Zakaria

Research output: Contribution to journalArticle

Abstract

Coronary artery fistulas (CAFs) are rare and mostly congenital anomalous connections between a coronary artery and a cardiac chamber or great vessel. Most CAFs are small, asymptomatic, and found incidentally during cardiac imaging. However, they can lead to serious complications including myocardial infarction, congestive heart failure, arrhythmias, or fistula rupture. CAFs have been associated with infective endocarditis, but to our knowledge, this complication has never been reported involving an isolated CAF to an otherwise anatomically normal great vessel. We report the first case of this complication in a 49-year-old man with a presumed streptococcus vegetation found within an isolated large, tortuous CAF connecting the right coronary artery to the superior vena cava. After completing antibiotic treatment, transcatheter closure of the CAF was performed. Since then, the patient has remained symptom-free. This case demonstrates that CAF closure is feasible following CAF-associated endocarditis, and that closure may represent a viable strategy for reducing risk of recurrent infection.

Original languageEnglish (US)
Pages (from-to)620-624
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume85
Issue number4
DOIs
StatePublished - Mar 1 2015

Keywords

  • Angiography
  • Anomalous coronaries
  • Closure
  • Coronary
  • Fistula/shunts
  • Vascular access

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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