Arq. Bras. Cardiol. 2021; 116(5): 999-1002
Persistent Aneurysm of the Right Coronary Artery, Even after Correction of a Fistula with the Right Ventricle
Introduction
Among the coronary-cavitary fistulas, the most commonly found type corresponds to that involving the right coronary artery and the right cardiac cavities, with corresponding volume overload due to arteriovenous deviation. The clinical manifestations correspond to heart failure, angina with myocardial infarction and arrhythmias. A continuous murmur easily suggests the diagnosis of a congenital defect, which is consolidated by the imaging examinations. Other fistulas should always be suspected in the differential diagnosis, such as the patent ductus arteriosus, aortopulmonary window, systemic-pulmonary collaterals, and fistulas of the sinus of Valsalva with the right ventricle cavity. Cardiac surgery and / or percutaneous interventions comprise the therapeutic basis for fistula resolution. Little is said, however, about the evolution after the procedures, given that the previous coronary dilation persists and may constitute another evolution problem in the longer term.
This aspect comprises the main reason for this assessment.
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