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Coronary interventions

A curly case: dissecting giant arteriovenous anomaly - left main coronary artery shunting to superior vena cava

EuroIntervention 2015;11:e1 published online e-article October 2015. DOI: 10.4244/EIJV11I6A132

1. Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands; 2. Department of Cardiology, Thoraxcenter, Erasmus University MC, Rotterdam, The Netherlands; 3. Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Nethe
A 52-year-old female patient with an unremarkable history was admitted to our institution with a non-ST-elevation myocardial infarction (NSTEMI) and underwent coronary angiography (CAG) the following day.

The right coronary artery (RCA) was normal. The left main coronary artery (LMCA) was very large, had a tortuous course and seemed to fistulise to the right atrium (RA). The left anterior descending (LAD) and circumflex (Cx) also originated from this LMCA and had only minor wall irregularities. During the procedure, a dissection emerged proximal in this arteriovenous fistula, large ST elevations appeared, the patient developed ventricular fibrillation and was resuscitated (Figure 1...

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