Spontaneous closure of iatrogenic coronary artery fistula to left ventricle after septal myectomy for hypertrophic obstructive cardiomyopathy

Jeong Choi Yu, Cheol Woong Yu, Ki Park Man, Il Park Joong, Uk Kwon Sung, Sang Chol Lee, Jae Lee Heung, Woo Park Seung

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Cases of iatrogenic coronary artery fistulas draining into the left ventricle after surgical myectomy for hypertrophic obstructive cardiomyopathy have been published as sporadic reports. However, its management scheme and prognosis are not clear because of the low incidence. A 46-yr-old woman was hospitalized for evaluation of chest pain and shortness of breath for 3 months. Transthoracic echocardiographic examination showed typical hypertrophic obstructive cardiomyopathy with a peak pressure gradient of 71 mmHg across the left ventricular outflow tract. The patient underwent surgical septal myectomy. Postoperative color Doppler imaging revealed a diastolic blood flow from the interventricular septal myocardium to the left ventricular cavity, i.e. iatrogenic coronary artery fistula to the left ventricle. Ten days later, the fistula closed spontaneously which was diagnosed by transthoracic echocardiography and confirmed by coronary angiography.

Original languageEnglish
Pages (from-to)1111-1114
Number of pages4
JournalJournal of Korean medical science
Issue number6
Publication statusPublished - 2006 Dec 1
Externally publishedYes



  • Cardiomyopathy hypertrophic
  • Postoperative complications
  • Vascular fistula

ASJC Scopus subject areas

  • Medicine(all)

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