Find in Library

We report a case of acquired multiple coronary microfistulas between left anterior descending coronary artery and left ventricle following myocardial infarction (MI), revealed after coronary angioplasty. Acquired coronary cameral fistulas have been described following a variety of interventions including coronary artery bypass surgery, valve replacement, cardiac transplantation, endomyocardial biopsy, septal myectomy, and coronary angioplasty. In addition, prior MI and severe atherosclerosis can also open up the vessels of Wearn and establish a direct communication with the cardiac chambers. The fistulas appeared in our case were small, multiple, and distal and did not produce any symptoms. Immediate appearance of these fistulas following percutaneous revascularization might be alarming. Awareness of this delayed consequence of myocardial ischemia aids in appropriate management. Relevant reports in the literature are briefly discussed.