Endovascular treatment of inadvertent left internal mammarian artery to great cardiac vein fistula

Abstract

Inadvertent left internal mammarian artery to coronary sinus anastomosis is a rare complication of coronary artery by-pass graft surgery. Management of this iatrogenic complication is controversial with conservative, surgical and endovascular options possible. Endovascular treatment offers a minimally invasive approach with a wide variety of embolic agents with different success rates. Herein we present a case of an iatrogenic left internal mammarian artery to coronary sinus anastomosis treated by detachable coil embolization. Use of detachable coil offers more precise deployment that is essential in the treatment of an iatrogenic left internal mammarian artery to coronary sinus anastomosis which can present challenges due to high flow rates and coil migration.

Keywords

• Coronary artery bypass graft
• Coil embolization
• Arteriovenous fistula