Arterio-atrial shunting in coronary atherosclerosis.

Two patients with abnormal communications between the right coronary artery and right atrium were observed during selective coronary arteriography. The arterio-atrial communication in these two patients appeared to differ from previously described fistulous communications in this location, most of which had been thought to be congenital. The patients in this study were older, the fistulous communication was smaller, and there was severe atherosclerosis of the right coronary artery. Because of these differences, it is postulated that these abnormal communications may, in fact, be a consequence of coronary atherosclerosis. Presumably, normal arteriole to atrial channels become dilated in branches of the coronary artery proximal to the site of occlusion. Whereas collateral vessels that develop at other sites in patients with coronary atherosclerosis are thought to be of functional benefit, the arterio-atrial shunts described in this report may have a detrimental effect on the patients involved.

[1]  R. Barnes,et al.  Coronary artery fistula. , 1969, British heart journal.

[2]  J. Shaver,et al.  A case of anomalous right coronary artery to right atrial fistula presenting as atypical aortic insufficiency. , 1969, The American journal of cardiology.

[3]  J. Rees The myocardial collateral circulation. , 1969, British heart journal.

[4]  H. Gale,et al.  Coronary artery--right heart fistulas. , 1967, The Journal of thoracic and cardiovascular surgery.

[5]  C. Kittle,et al.  Congenital coronary artery fistula. Indications for operative treatment. , 1966, Archives of surgery.

[6]  M. Yokoyama,et al.  Coronary arteriovenous fistula: Nine operated cases , 1966 .

[7]  V. O. Bjoerk,et al.  CORONARY ARTERY FISTULA. , 1965 .

[8]  S. Mackler,et al.  Coronary arteriovenous fistula with patent ductus arteriosus. , 1963, American heart journal.

[9]  D. Carmichael,et al.  Congenital coronary arteriovenous fistula. , 1961, The American journal of cardiology.

[10]  C. Lillehei,et al.  Congenital Communication of a Coronary Artery with a Cardiac Chamber or the Pulmonary Trunk ("Coronary Artery Fistula") , 1961 .

[11]  H. Thompson,et al.  Preoperative Evaluation of a Continuous Murmur in the Chest , 1961 .

[12]  R. Fraser,et al.  Aneurysm of the right coronary artery. Rupture into the right atrium with survival for one year. , 1960, The American journal of cardiology.

[13]  F. Robicsek,et al.  The diagnosis and treatment of coronary arteriovenous fistula. , 1959, Surgery.

[14]  H. Wedell,et al.  Congenital communication between the right coronary artery and the right atrium. , 1959, Quarterly bulletin. Northwestern University (Evanston, Ill.). Medical School.

[15]  J. Edwards,et al.  Congenital communication between the right coronary artery and the right atrium. , 1958, The Journal of thoracic surgery.

[16]  E. Braunwald,et al.  Symposium on Diagnostic Methods in the Study of Left‐to‐Right Shunts , 1957, Circulation.

[17]  G. Rowe,et al.  Large congenital aneurysm of the right coronary artery. , 1957, A.M.A. archives of pathology.

[18]  B. Gasul,et al.  Anomalous coronary artery simulating patent ductus arteriosus. , 1956, Journal of the American Medical Association.

[19]  J. Colbeck,et al.  Coronary aneurysm with arteriovenous fistula. , 1954, American heart journal.

[20]  P. N. Harris Aneurysmal Dilatation of the Cardiac Coronary Arteries: Review of the Literature and Report of a Case. , 1937, The American journal of pathology.