Percutaneous treatment of huge congenital coronary-cameral fistula

Ozet– On bir yasindaki kiz cocugu halsizlik, efor dispnesi ve gogus agrisi sikayetleri ile hastanemize basvurdu. Transtorasik ekokardiyografide, parasternal kisa aks ve apikal dort bosluk renkli Doppler akim incelemelerinde koroner sinus seviyesinde sag ventrikule dokulen bir yapi izlendi. Cok kesitli bilgisayarli tomografide bu yapinin sirkumfleks arter oldugu ve trikuspit septal kapakcigi komsulugunda sag ventrikule dokuldugu goruldu. Hesaplanan Qp/Qs degeri 1.6 idi. Koroner arterlerle kalp odaciklari arasinda baglanti olan dogumsal koroner-odacik fistulleri oldukca nadir durumdur. Koroner arter fistulu genellikle semptomsuz olmasina ragmen santin ciddiyetine bagli olarak ciddi semptomlara da neden olabilirler ve tibbi, cerrahi ya da transkatater yolla tedavi edilebilirler. Bu olgu bildirisinde, sirkumfleks arterden sag ventrikule dogru olan fistulun dukt kapama cihazi ile basarili bir sekilde tedavi edildigi hasta sunuldu. Summary– An 11-year-old girl was admitted to our hospital with a history of fatigue, effort dyspnea, and chest pain. On transthoracic echocardiography, the parasternal shortaxis and apical four-chamber color Doppler flow imaging showed a structure matching the level of the coronary sinus and pouring into the right ventricle. On multi-slice computed tomography, the circumflex artery became immediately narrowed just before draining in to the base of the right ventricle, close to the septal leaflet of the tricuspid leaflet, and the Qp/Qs was 1.6. Congenital coronary-cameral fistula is an infrequent condition that establishes a direct link between coronary arteries and cardiac chambers. Although coronary artery fistulae are commonly asymptomatic, they may cause severe symptoms depending on the severity of the shunt, and may be treated medically, surgically or by transcatheter closure. In this case report, we present a patient with a huge circumflex artery-to-right ventricle fistula treated successfully with a duct occluder device. 168