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Regression Of A Coronary Arterial Fistula In An Infant With Pulmonary Atresia And An Intact Ventricular Septum

Popoiu et al., 2010Other/Unknown

Popoiu, A., Eicken, A., Genz, T., Schreiber, C., & Hess, J. (2010). Regression of a coronary arterial fistula in an infant with pulmonary atresia and an intact ventricular septum. Pediatric cardiology, 31(1), 144–146. https://doi.org/10.1007/s00246-009-9559-2

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Abstract

This report describes a premature newborn with pulmonary atresia and an intact ventricular septum who presented with a significant fistula between the right ventricle and the left anterior descending coronary artery (LAD). The right ventricle was not decompressed to prevent myocardial damage. After 2 months, the fistula had closed spontaneously. The pulmonary valve was opened, and biventricular circulation was achieved.

Case Details

Disease Location

Heart

Personal Characteristics

Premature newborn boy (34 weeks gestation, 2.2 kg) with cyanosis and respiratory distress.

Clinical Characteristics

Significant fistula between the right ventricle and the left anterior descending coronary artery.

Remission Characteristics

After 2 months of last clinical visit, the fistula closed spontaneously. The pulmonary valve was opened and biventricular circulation was achieved.

Treatment & Mechanisms

Proposed Remission Mechanisms

Later decompression of the right ventricle followed by a biventricular circulation

Clinical Treatment

Prostaglandin e2. Balloon atrial septemberostomy. Systemic to-pulmonary arterial shunt and atrioseptemberotomy. Ductus closed surgically.