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Clin. Cardiol. 24, 630–632 (2001)
Paul Wexberg, M.D., Michael Gottsauner-Wolf, M.D., Katharina Kiss, M.D., Günter Steurer, M.D., Dietmar Glogar, M.D., FESC
Department of Cardiology, Clinic for Internal Medicine II, University of Vienna, Vienna, Austria
Summary: We present the case of a 67-year-old man in whom a guidewire broke at rotablation of the right coronary artery, creating an iatrogenic aneurysmal arteriovenous fistula to the coronary sinus. Successful Doppler wire-guided fistula occlusion by percutaneous coil embolization lead to normalization of coronary blood flow and relief of the patient's symptoms. Myocardial ischemia in this patient may have been due to a steal phenomenon caused by coronary artery fistulae, as suggested by blood flow velocity data obtained before and after fistula occlusion.
Key words: coronary artery fistula, coil embolization, coronary blood flow, rotational atherectomy
Address for reprints:
Paul Wexberg, M.D.
Department of Cardiology
Clinic for Internal Medicine II
University of Vienna
Währinger Gürtel 18-20
A-1090 Vienna, Austria
e-mail: pwexberg@pop3.kard.akh-wien.ac.at
Received: July 7, 1999
Accepted: January 5, 2000