[A rare cause of a continuous murmur. Our experience with a newborn infant with a congenital coronary fistula]. 1994

S Guarnera, and P Sciacca, and L Patanè, and I Bianca, and M G Parisi, and M Abbate, and G Giuffrida, and G Distefano
Istituto di Cardiologia, Università di Catania, Italia.

Congenital coronary artery fistulas are very rare. The most common connect one of the two coronary arteries with the right cardiac chambers, in particular the right ventricle. So, a left to right shunt appears; furthermore ischemic problems are possible. Notwithstanding in the pediatric age subset the patients are usually free of symptoms. The most important clinical sign is a continuous murmur in the precordium. We report a case of a newborn with a fistula between the right coronary artery and the right ventricle. He presented with the typical murmur; ECG and chest-ray were considered as normal. Echocardiography did not do the diagnosis, and the baby was submitted to a cardiac catheterization. There was a mild left to right shunt (QP/QS = 1.5/1), without pulmonary hypertension. The diagnosis was done by selective coronary angiography. We decided not to close the fistula, and the baby was discharged. Three months later he is still well. In this discussion we consider indications for surgery, and hypothesize a wider application in the future of transcutaneous embolization.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D003330 Coronary Vessel Anomalies Malformations of CORONARY VESSELS, either arteries or veins. Included are anomalous origins of coronary arteries; ARTERIOVENOUS FISTULA; CORONARY ANEURYSM; MYOCARDIAL BRIDGING; and others. Anomaly, Coronary Vessel,Coronary Vessel Anomaly
D006337 Heart Murmurs Heart sounds caused by vibrations resulting from the flow of blood through the heart. Heart murmurs can be examined by HEART AUSCULTATION, and analyzed by their intensity (6 grades), duration, timing (systolic, diastolic, or continuous), location, transmission, and quality (musical, vibratory, blowing, etc). Cardiac Murmurs,Diastolic Murmurs,Innocent Murmurs,Cardiac Murmur,Diastolic Murmur,Heart Murmur,Innocent Murmur,Murmur, Cardiac,Murmur, Diastolic,Murmur, Heart,Murmur, Innocent,Murmurs, Cardiac,Murmurs, Diastolic,Murmurs, Heart,Murmurs, Innocent
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001164 Arteriovenous Fistula An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE. Aneurysm, Arteriovenous,Arteriovenous Aneurysm,Arteriovenous Fistulas,Fistula, Arteriovenous,Fistulas, Arteriovenous

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