Author + information
- Received September 12, 2012
- Accepted September 26, 2012
- Published online April 2, 2013.
- Saktheeswaran Mahesh Kumar, MD, DM,
- Subramanian Venkateshwaran, MD, DM,
- Sasidharan Bijulal, MD, DM,
- Kavassery Mahadevan Krishnamoorthy, MD, DM,
- Sivasubramonian Sivasankaran, MD, DM and
- Jaganmohan A. Tharakan, MD, DM
An asymptomatic 9-year-old girl was referred for evaluation of systolic murmur at the base of the heart. Echocardiography showed continuous flow from the region of left circumflex coronary artery (LCX) to the superior vena cava (SVC) suggestive of a coronary arteriovenous fistula (A) with normal left anterior descending (LAD) and right coronary arteries (RCA), which was confirmed by 256-slice computed tomography (CT) (B, C). Real-time 3-dimensional transesophageal echocardiography (RT3DTEE) clearly showed the opening of the aneurismal fistula to the SVC and its dimensions (D, E,Online Video 1). Under RT3DTEE guidance a percutaneous arteriovenous loop was formed (F), and the fistula closed at the venous end with an Amplatzer Duct Occluder II (6 × 6 mm) device (St. Jude Medical, St. Paul, Minnesota) (G, H,Online Video 2) without compromising the coronary flow. The RT3DTEE helped in sizing the defect, appropriate device selection, and closure. PA = pulmonary artery.
- Received September 12, 2012.
- Accepted September 26, 2012.
- American College of Cardiology Foundation