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CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 |
doi: 10.3389/fcvm.2025.1498359
"Dumbbell" giant right coronary artery ectasia with right atrium fistula: a case report. Authors
Provisionally accepted- Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
A 50-year-old female patient had a "dumbbell" giant right coronary artery ectasia characterized by two artery dilation segments both reaching the level of giant aneurysm with a normal segment between them. Computed tomography angiography showed a fistula sac in the right atrium. The vessel shape represents a typical type IV (localized or segmental) coronary artery ectasia rarely having real imaging. The patient had experienced a 3-year chest tightness, without dyspnea, worsened by physical activity. Additional tests indicated her having mitral valve regurgitation, superficial myocardial bridge, and anemia, which led to a comprehensive effect contributing to the symptom development. She felt relieved after successful coronary artery fistula repair, mitral valvuloplasty, and fistula sac removal. At the 6-month follow-up, no complication was found according to echocardiography. Coronary aneurysm patients can be asymptomatic at the early stage, while this case indicates that the dumbbell shape may be an developing stage of giant coronary aneurysm whose origin and close-fistula segments are influenced by separate hydrodynamics during ectasia or aneurysm formation.
Keywords: cardiovascular surgery, case report, computed tomography angiography, Coronary artery ectasia, Coronary artery fistula
Received: 18 Sep 2024; Accepted: 07 Feb 2025.
Copyright: © 2025 Shan, Wang and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianggui Shan, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Heng Wang, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Song Xue, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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