PMC7640565_01
Right anterior oblique coronary angiogram (RAO) showing a fistula connecting distal LAD to the right ventricle.
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A coronary angiogram showed a large fistula draining from the distal part of the LAD to the right ventricle (Fig. 1).
Apical 4-chamber view 2D image (left) and color doppler (right) demonstrating fistula (single arrow) and diastolic flow (double arrow) into the Right Ventricle (RV) with Qp/Qs ratio > 1. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Occlusion of distal Left Anterior Descending Artery (LAD) at fistula, Improved flow in distal LAD after deployment of stent.
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Extra Back up guiding catheter was positioned with microcatheter in distal LAD, predilatation by balloon 1.5 mm then 2.5 mm, verification of the occlusion of the fistula (Fig. 3) and a 2.5 x 16mm covered stent type BeGraft was deployed.
Reappearance of a small shunt after disinflation of the balloon.
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The result was the reappearance of a small shunt after disinflation of the balloon (Fig. 4).