Heart failure due to giant congenital aorto‐right atrial fistula: report of a case

• Published in: International journal of clinical practice (Esher) Vol. 59; no. 147; pp. 9 - 11
• Main Authors: Hsu, J‐T, Ho, W‐J, Wang, C‐L, Cheng, N‐J
• Format: Journal Article
• Language: English
• Published: Oxford, UK; Malden, USA Blackwell Publishing Ltd/Inc 01.04.2005; Hindawi Limited
• Subjects: Aorta - abnormalities; Aorta - diagnostic imaging; Arteriovenous Fistula - complications; Arteriovenous Fistula - congenital; Arteriovenous Fistula - diagnostic imaging; Case studies; Coronary atrio‐venous fistula (CAVF); Coronary Vessel Anomalies - complications; Coronary Vessel Anomalies - diagnostic imaging; Coronary vessels; Echocardiography, Transesophageal; Heart Atria - abnormalities; Heart Atria - diagnostic imaging; Heart failure; Heart Failure - etiology; Humans; Male; Middle Aged; right atrium (RA); Surgery; transesophageal echocardiography (TEE); transthoracic echocardiography (TTE)
• ISSN: 1368-5031; 1368-504X; 1742-1241
• DOI: 10.1111/j.1368-504X.2005.00302.x

Summary Coronary arterio‐venous fistula (CAVF) is a rare coronary artery anomaly. We demonstrated the rare findings of a large congenital aorto‐right atrial fistula with initial presentation of heart failure symptoms. Transthoracic echocardiography and transesophageal echocardiography made the accurate diagnosis. Further haemodynamic and angiographic study proved this large CAVF with extraordinary oxygen saturation step‐up (26%) and large pulmonary to systemic shunt (Qp/Qs = 4.25). It was corrected by surgery because of evidence of heart failure and the possible risk of endocarditis and coronary steal effect.