PMC9856336_01
Coronary computed tomography angiography. (A) Case 1: Giant aneurysmal right coronary artery and severely aneurysmal right posterior lateral branch with fistulous connection to severely dilated coronary sinus, (B) Case 2: Giant aneurysmal LCx with fistulous connection to severely dilated coronary sinus.
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Coronary CTA revealed an aneurysmal left main artery (1.6 x 1.4 cm) and a giant left circumflex artery (LCx) aneurysm distally (proximal 1.4 x 1.2 cm, mid 1.7 x 1.6 cm, distal up to 3.5 cm with inlet 0.9 x 0.5 cm and outlet 1.8 x 1.5 cm) with fistulous connection to a severely dilated CS (4.1 cm with inlet 0.3 x 0.3 cm and outlet 0.5 x 0.4 cm; Figure 1B).
Three-dimensional printout models. (A) Case 1: Three-dimensional model demonstrating fistula to be circular and ~6 mm in diameter. (B) Case 1: 8 mm Amplatzer Septal Occluder with adequate seating and rim apposition within the fistula. (C) Case 2: Three-dimensional model demonstrating fistula to be circular and ~4 mm in diameter.
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Multiplanar 3D printout models demonstrated the fistula to be singular, circular in anatomy, and ~4 mm in diameter (Figure 2C).
Percutaneous closure of fistula. Amplatzer Septal Occluder device released with significantly reduced flow into the coronary sinus. (A) Case 1. (B) Case 2.
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PMC9856336_02_ytad011f3.jpg
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Torqvue system was used to load and deploy a 5 mm Amplatzer Septal Occluder across the fistula under angiographic and TEE guidance. The device was released without impingement on adjacent structures, and final angiography showed complete closure of the fistula (Figure 3B).
Coronary computed tomography angiography. Confirmation of Amplatzer Septal Occluder device placement in Case 1.
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Final angiography showed complete closure of the fistula (Figures 3A and 4).
PMC9856336_02
Coronary computed tomography angiography. (A) Case 1: Giant aneurysmal right coronary artery and severely aneurysmal right posterior lateral branch with fistulous connection to severely dilated coronary sinus, (B) Case 2: Giant aneurysmal LCx with fistulous connection to severely dilated coronary sinus.
ytad011f1.jpg
PMC9856336_02_ytad011f1.jpg
ytad011-F1
Coronary CTA revealed an aneurysmal left main artery (1.6 x 1.4 cm) and a giant left circumflex artery (LCx) aneurysm distally (proximal 1.4 x 1.2 cm, mid 1.7 x 1.6 cm, distal up to 3.5 cm with inlet 0.9 x 0.5 cm and outlet 1.8 x 1.5 cm) with fistulous connection to a severely dilated CS (4.1 cm with inlet 0.3 x 0.3 cm and outlet 0.5 x 0.4 cm; Figure 1B).
Three-dimensional printout models. (A) Case 1: Three-dimensional model demonstrating fistula to be circular and ~6 mm in diameter. (B) Case 1: 8 mm Amplatzer Septal Occluder with adequate seating and rim apposition within the fistula. (C) Case 2: Three-dimensional model demonstrating fistula to be circular and ~4 mm in diameter.
ytad011f2.jpg
PMC9856336_02_ytad011f2.jpg
ytad011-F2
Multiplanar 3D printout models demonstrated the fistula to be singular, circular in anatomy, and ~4 mm in diameter (Figure 2C).
Percutaneous closure of fistula. Amplatzer Septal Occluder device released with significantly reduced flow into the coronary sinus. (A) Case 1. (B) Case 2.
ytad011f3.jpg
PMC9856336_02_ytad011f3.jpg
ytad011-F3
Torqvue system was used to load and deploy a 5 mm Amplatzer Septal Occluder across the fistula under angiographic and TEE guidance. The device was released without impingement on adjacent structures, and final angiography showed complete closure of the fistula (Figure 3B).