AUTHOR=Sun Shi-Bin , Kong Zhongzheng , Farhaj Zeeshan , Hongxin Li 

TITLE=Case report: Percoronary device closure of tortuous coronary artery fistula into left atrium

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1106420

DOI=10.3389/fcvm.2023.1106420

ISSN=2297-055X

ABSTRACT=<p>Surgical ligation and transcatheter occlusion are the mainstream for the treatment of coronary artery fistulas (CAFs). However, these techniques applied to tortuous and aneurysmal CAF, especially those draining into left-heart, have their known drawbacks. We report, a successful percoronary device closure of such CAF, originating from left main coronary artery and draining into left atrium, through a left subaxillary minithoracotomy. Through a puncture on the distal straight course, we occluded CAF exclusively under transesophageal echocardiography guidance. Complete occlusion was achieved. It’s a simple, safe, and effective alternative for tortuous, large, and aneurysmal CAFs draining into the left heart.</p>