A case report of superior vena cava/right coronary artery fistula secondary to chronic endocarditis

Author:

Kiel Michaela D1,Prathivadhi-Bhayankaram Sruti2ORCID,Singhal Arun K3,Ashwath Mahi L24ORCID

Affiliation:

1. University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52241, USA

2. Department of Internal Medicine, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52241, USA

3. Department of Cardiothoracic Surgery, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52241, USA

4. Heart and Vascular Center, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52241, USA

Abstract

Abstract Background Coronary arteriovenous fistulas present an abnormal connection between the coronary arteries and an adjacent systemic or pulmonary vessel. They are rare, representing 0.002% of the general population. The majority is congenital but may additionally occur related to trauma or interventional cardiac procedures. Case summary We present the case of a 48-year-old male with a history of untreated bacterial endocarditis developing a right coronary/superior vena cava fistula. We detail the imaging findings of this rare phenomenon to arrive at this diagnosis. We describe his clinical course and the interventions considered, including surgical extraction. Unfortunately, this patient left against medical advice before completing recommended treatment. Discussion We present the first documentation of a right coronary/superior vena cava fistula secondary to chronic untreated bacterial endocarditis. Clinicians should be aware of this rare complication.

Publisher

Oxford University Press (OUP)

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