Percutaneous treatment of an iatrogenic cardiac fistula

Coronary fistulae, defined as communications between coronary arteries and cardiac chambers or veins, are uncommon. We present a case where a fistula was inadvertently caused by the surgical anastomosis of an arterial coronary artery bypass graft to a coronary vein. This produced two coronary problems, the unrevascularized Cx territory and a coronary arteriovenous fistula, and left the patient with symptoms. Each of these problems was addressed in a tailored percutaneous intervention by deploying ostial and distal stents to revascularize the Cx, followed by coils to block the distal section of the graft.