Volume 5, Issue 3, May 2019, Page: 56-59
Case Report: A Rare Case of Coronary-Bronchial Fistula Associated with a Large Lung Bullae and Bronchiectasis Presenting as Dyspnea
Farid Maalouf, Cardiology Department, Saint George Hospital University, Medical Center, Balamand University, Beirut, Lebanon
Nadine Kawkabani, Cardiac Anesthesia Department, Saint George Hospital University, Medical Center Balamand University, Beirut, Lebanon
Simon Bejjani, Cardiothoracic Surgery Department, Saint George Hospital, Medical Center, Balamand University, Beirut, Lebanon
Omar Boustros, Cardiothoracic Surgery Department, Saint George Hospital, Medical Center, Balamand University, Beirut, Lebanon
Nabil Khoury, Respiratory and Critical Care Department, Saint George Hospital, Medical Center, Balamand University, Beirut, Lebanon
Abbas Chamsuddin, Interventional Radiology Department, Saint George Hospital, Medical Center, Balamand, University, Beirut, Lebanon
Rola Darwish, Cardiac Anesthesia Department, Saint George Hospital University, Medical Center Balamand University, Beirut, Lebanon
Pierrette Habib, Cardiology Department, Saint George Hospital University, Medical Center, Balamand University, Beirut, Lebanon
Bassam Abou Khalil, Cardiothoracic Surgery Department, Saint George Hospital, Medical Center, Balamand University, Beirut, Lebanon
Paul Charbel, Cardiology Department, Saint George Hospital University, Medical Center, Balamand University, Beirut, Lebanon
Received: May 29, 2019;       Accepted: Jun. 29, 2019;       Published: Jul. 11, 2019
DOI: 10.11648/j.ijcts.20190503.11      View  177      Downloads  36
Abstract
Coronary artery fistulas (CAF) are rare but hemodynamically significant anomalies. Although asymptomatic, they can be associated with several cardiorespiratory conditions. Coronary to bronchial fistulas (CBF) account for 0.5% to 0.61% of coronary artery fistulas, with fistulas arising from the right coronary artery being exceedingly rare. These fistulas are known to be associated with bronchiectasis but not lung bullae. The following paper reports a rare case of a coronary to bronchial fistula associated to bronchiectasis and lung bullae. The patient presented for dyspnea and was found to have a large lung bullae, bronchiectasis and a coronary to bronchial artery fistula arising from the right coronary artery and terminating into the left bronchial artery. The CBF was successfully managed first with percutaneous microcoil embolization then the bullae was resected thoracoscopically three days later. However, more case reports are mandatory in order to further understand the etiology and pathophysiology of these fistulas, elucidate their relationship to other pathologies such as bronchiectasis and lung bullae and determine the optimal therapeutic measures.
Keywords
Coronary Bronchial Artery Fistula, Bronchiectasis, Lung Bullae, Microcoil Embolization
To cite this article
Farid Maalouf, Nadine Kawkabani, Simon Bejjani, Omar Boustros, Nabil Khoury, Abbas Chamsuddin, Rola Darwish, Pierrette Habib, Bassam Abou Khalil, Paul Charbel, Case Report: A Rare Case of Coronary-Bronchial Fistula Associated with a Large Lung Bullae and Bronchiectasis Presenting as Dyspnea, International Journal of Cardiovascular and Thoracic Surgery. Vol. 5, No. 3, 2019, pp. 56-59. doi: 10.11648/j.ijcts.20190503.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Yun G, Nam TH, Chun EJ. Coronary Artery Fistulas: Pathophysiology, Imaging Findings, and Management. RadioGraphics. 2018 Mar 30; 38 (3): 688-703.
[2]
Loukas M, Germain AS, Gabriel A, John A, Tubbs RS, Spicer D. Coronary artery fistula: a review. Cardiovascular Pathology. 2015 May 1; 24 (3): 141-8.
[3]
Reidy JF, Anjos RT, Qureshi SA, Baker EJ, Tynan MJ. Transcatheter embolization in the treatment of coronary artery fistulas. Journal of the American College of Cardiology. 1991 Jul 1; 18 (1): 187-92.
[4]
Ata Y, Turk T, Bicer M, Yalcin M, Ata F, Yavuz S. Coronary arteriovenous fistulas in the adults: natural history and management strategies. Journal of cardiothoracic surgery. 2009 Dec; 4 (1): 62.
[5]
Erdem K, Ozbay Y. Prevalence and Characteristics of Coronary Artery Anomalies Using Invasive Coronary Angiography in 6237 Consecutive Patients in a Single Center in Turkey. Archives of Iranian Medicine. 2018 Jun 1; 21 (6): 240.
[6]
Lim JJ, Jung JI, Lee BY, Lee HG. Prevalence and types of coronary artery fistulas detected with coronary CT angiography. American Journal of Roentgenology. 2014 Sep; 203 (3): W237-43.
[7]
Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Catheterization and cardiovascular diagnosis. 1990 Sep; 21 (1): 28-40.
[8]
Said SA, Oortman RM, Hofstra JH, et al. Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature. Neth Heart J. 2014; 22: 139–47. doi: 10.1007/s12471-014-0518-z.
[9]
Challoumas D, Pericleous A, Dimitrakaki IA, Danelatos C, Dimitrakakis G. Coronary arteriovenous fistulae: a review. International Journal of Angiology. 2014 Mar; 23 (01): 001-10.
[10]
Lee WS, Lee SA, Chee HK, Hwang JJ, Park JB, Lee JH. Coronary-bronchial artery fistula manifested by hemoptysis and myocardial ischemia in a patient with bronchiectasis. Korean J Thorac Cardiovasc Surg. 2012; 45: 49–52. doi: 10.5090/kjtcs.2012.45.1.49
[11]
Galli E, Rizza A, Remoli E, Tognarelli A, Palmieri C, Chiappino D, Berti S. Coronary-to-bronchial artery fistula in a patient with angina. Journal of cardiology cases. 2013 Feb 1; 7 (2): e45-7.
[12]
Hackett DA, Hallidie-Smith KA. Spontaneous closure of coronary artery fistula. British heart journal. 1984 Oct; 52 (4): 477.
[13]
Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, del Nido P, Fasules JW, Graham TP, Hijazi ZM, Hunt SA. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American college of cardiology/American heart association task force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease) developed in collaboration with the american society of echocardiography, heart rhythm society, international society for adult congenital heart disease, society for cardiovascular angiography and interventions, and .... Journal of the American College of Cardiology. 2008 Dec 2; 52 (23): e143-263.
[14]
Ilkay E, Celebi OO, Kacmaz F, Ozeke O. Percutaneous closure of coronary artery fistula: long-term follow-up results. Postępy w Kardiologii Interwencyjnej= Advances in Interventional Cardiology. 2015; 11 (4): 318.
[15]
Armsby LR, Keane JF, Sherwood MC, Forbess JM, Perry SB, Lock JE. Management of coronary artery fistulae: patient selection and results of transcatheter closure. Journal of the American College of Cardiology. 2002 Mar 20; 39 (6): 1026-32.
[16]
Jama A, Barsoum M, Bjarnason H, Holmes DR, Rihal CS. Percutaneous closure of congenital coronary artery fistulae: results and angiographic follow-up. JACC: Cardiovascular Interventions. 2011 Jul 1; 4 (7): 814-21.
[17]
Zhang W, Hu R, Zhang L, Zhu H, Zhang H. Outcomes of surgical repair of pediatric coronary artery fistulas. The Journal of thoracic and cardiovascular surgery. 2016 Oct 1; 152 (4): 1123-30.
[18]
Labbé H, Bordeleau S, Drouin C, Archambault P. Myocardial infarction as a complication of bronchial artery embolization. Cardiovascular and interventional radiology. 2017 Mar 1; 40 (3): 460-4.
[19]
Güngör H, Zencir C, Akgüllü Ç, Eryılmaz U. A practical solution for coil migration and coronary artery dissection in the same patient with coronary artery fistula. International Journal of the Cardiovascular Academy. 2016 Mar 1; 2 (1): 25-6.
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