{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:21:14Z","timestamp":1792178474348,"version":"4.4.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Structural Heart Disease Intervention"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary fistula are rare and often present in early adulthood with symptoms of right heart overload from left to right shunting or ischaemia in the distal coronary bed due to coronary steal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 73-year-old lady with prior history of supraventricular tachycardia, dyslipidemia and a right coronary artery (RCA) to coronary sinus (CS) fistula, presented with progressive angina. She did not have evidence of ischaemia in the RCA territory on nuclear imaging, and cardiac computed tomography (CT) did not show coronary artery disease but revealed a significantly dilated CS and coronary venous tree. She was found to have CS ostial stenosis and, under transesophageal echocardiographic guidance, underwent successful balloon angioplasty of the CS ostium, with decompression of the coronary venous circulation and resolution of her angina.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Coronary fistula draining to the CS are rare, and association with CS ostial stenosis has been reported very infrequently. CS ostial stenosis can cause elevated coronary venous pressure, leading to decreased global coronary perfusion and symptoms of angina or heart failure. Previous case reports of coronary fistula and CS ostial stenosis were treated with either medical therapy or surgery, and our case is the first to our knowledge to report successful percutaneous treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac121","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T12:22:42Z","timestamp":1647606162000},"source":"Crossref","is-referenced-by-count":3,"title":["An unusual pair: coronary artery fistula and coronary sinus ostium stenosis as a cause of refractory angina"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5692-2616","authenticated-orcid":false,"given":"Ada C.","family":"Stefanescu Schmidt","sequence":"first","affiliation":[{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network , Toronto, Ontario, Canada"},{"name":"Division of Cardiology, Massachusetts General Hospital , Boston, MA 02114, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahira","family":"Redwood","sequence":"additional","affiliation":[{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Alonso-Gonzalez","sequence":"additional","affiliation":[{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melitta","family":"Mezody","sequence":"additional","affiliation":[{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Horlick","sequence":"additional","affiliation":[{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"key":"2022053123240103900_ytac121-B1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/S0003-4975(99)01248-5","article-title":"Congenital heart surgery nomenclature and database project: anomalies of the coronary arteries","volume":"69","author":"Dodge-Khatami","year":"2000","journal-title":"Ann Thorac Surg"},{"key":"2022053123240103900_ytac121-B2","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur Heart J"},{"key":"2022053123240103900_ytac121-B3","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1016\/j.jacc.2018.08.1029","article-title":"2018 AHA\/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"73","author":"Stout","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022053123240103900_ytac121-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjcr\/ytaa297","article-title":"A case report of a coronary artery fistula to coronary sinus with giant aneurysm: risk does not end with repair","volume":"4","author":"Poretti","year":"2020","journal-title":"Eur Heart J Case Rep"},{"key":"2022053123240103900_ytac121-B5","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1510\/icvts.2011.283689","article-title":"Tortuous right coronary artery to coronary sinus fistula","volume":"13","author":"Mitropoulos","year":"2011","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2022053123240103900_ytac121-B6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4236\/wjcs.2016.612024","article-title":"Aneurysmal right coronary artery with Fistula to the coronary sinus: a case report","volume":"06","author":"Jenasamant","year":"2016","journal-title":"World J Cardiovasc Surg"},{"key":"2022053123240103900_ytac121-B7","doi-asserted-by":"crossref","first-page":"e31","DOI":"10.1016\/j.athoracsur.2018.10.071","article-title":"Coronary sinus stenosis with right coronary artery to coronary sinus fistula","volume":"108","author":"Bloomingdale","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2022053123240103900_ytac121-B8","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1111\/echo.13559","article-title":"Right coronary artery coronary sinus fistula with coronary sinus ostium stenosis","volume":"34","author":"Pu","year":"2017","journal-title":"Echocardiography"},{"key":"2022053123240103900_ytac121-B9","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1016\/j.jacc.2007.01.061","article-title":"Coronary sinus reducer stent for the treatment of chronic refractory angina pectoris: A prospective, open-label, multicenter, safety feasibility first-in-man study","volume":"49","author":"Banai","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2022053123240103900_ytac121-B10","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.cardfail.2012.01.003","article-title":"Percutaneous coronary sinus interventions to facilitate implantation of left ventricular lead: a case series and review of literature","volume":"18","author":"Oto","year":"2012","journal-title":"J Card Fail"},{"key":"2022053123240103900_ytac121-B11","doi-asserted-by":"crossref","first-page":"e008388","DOI":"10.1161\/CIRCEP.120.008388","article-title":"Risk of coronary sinus stenosis after epicardial radiofrequency ablation for mitral isthmus linear ablation","volume":"13","author":"Yamashita","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2022053123240103900_ytac121-B12","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1017\/S1047951120000918","article-title":"Coronary sinus stenosis: an underdiagnosed cause for paediatric exertional chest pain","volume":"30","author":"Hegde","year":"2020","journal-title":"Cardiol Young"},{"key":"2022053123240103900_ytac121-B13","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1177\/2150135114525646","article-title":"An unusual case of severe stenosis of the coronary sinus ostium in association with double inlet left ventricle","volume":"5","author":"Hidestrand","year":"2014","journal-title":"World J Pediatr Congenit Heart Surg"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac121\/42952442\/ytac121.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/5\/ytac121\/43616362\/ytac121.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/5\/ytac121\/43616362\/ytac121.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T23:24:33Z","timestamp":1654039473000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac121\/6550481"}},"subtitle":[],"editor":[{"given":"Amardeep Ghosh","family":"Dastidar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,3,18]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac121","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2022,3,18]]},"article-number":"ytac121"}}