{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:15:19Z","timestamp":1780546519863,"version":"3.54.1"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary-to-pulmonary artery fistula (CPF) is a rare disease, and its optimal treatment strategy remains controversial. Herein, we report a rare case of minimally invasive coil embolization of giant CPFs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 78-year-old man with a history of persistent atrial fibrillation and lumbar canal stenosis presented to our hospital with breathlessness. Cardiac computed tomography revealed giant CPFs inducing a significant left-to-right shunt (Qp\/Qs 1\/2.1) with a coronary artery aneurysm smaller than the size indicated for surgical treatment. To reduce the left-to-right shunt flow, coil embolization procedures for the fistulas were performed twice. Initially, the fistula arising from the right coronary artery was embolized using three Target\u00ae XXL (6 \u00d7 40\u2005mm, 5 \u00d7 20\u2005mm) and two Target\u00ae XL SOFT (4 \u00d7 12\u2005mm) coils (Stryker Inc., Tokyo, Japan). One month later, the fistulas arising separately from the left coronary artery were embolized. After the procedures, the major shunt flow disappeared angiographically, and Qp\/Qs significantly decreased to 1\/1.2. Additionally, the fractional flow reserve of the left coronary artery increased from 0.79 to 0.93, and cardiopulmonary exercise testing showed an improvement in his exercise tolerance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>In similar cases, a surgical procedure with ligation of the CPFs combined with resection of a small aneurysm and coronary artery bypass grafting would normally have been considered the best approach. However, endovascular treatment targeting only the fistulas was a superior strategy considering the patient\u2019s age. The coil embolization technique effectively controlled the shunt flow of the CPFs. This technique is considerably less invasive than surgical therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae006","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T17:46:02Z","timestamp":1704476762000},"source":"Crossref","is-referenced-by-count":2,"title":["Minimally invasive coil embolization for significant left-to-right shunts due to giant coronary-to-pulmonary artery fistulas: a case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-6835","authenticated-orcid":false,"given":"Sato","family":"Namura","sequence":"first","affiliation":[{"name":"Department of Cardiology, Yodogawa Christian Hospital , 1-7-50, Kunijima, Higashiyodogawa-ku , Osaka 533-0024, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5365-6239","authenticated-orcid":false,"given":"Hiroki","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yodogawa Christian Hospital , 1-7-50, Kunijima, Higashiyodogawa-ku , Osaka 533-0024, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3542-6661","authenticated-orcid":false,"given":"Ryo","family":"Nishio","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Yodogawa Christian Hospital , 1-7-50, Kunijima, Higashiyodogawa-ku , Osaka 533-0024, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0509-4304","authenticated-orcid":false,"given":"Hiroshi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Sumitomo Hospital Interventional Radiology Center , 5-3-20, Nakanoshima, Kita-ku , Osaka 530-0005, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,5]]},"reference":[{"key":"2024012016250779300_ytae006-B1","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.21037\/jtd.2019.06.60","article-title":"The characteristics of coronary-pulmonary artery fistulas and the effectivity of trans-catheter closure: a single center experience","volume":"11","author":"Liu","year":"2019","journal-title":"J Thorac Dis"},{"key":"2024012016250779300_ytae006-B2","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.3348\/kjr.2019.0331","article-title":"Coronary-to-pulmonary artery fistula in adults: natural history and management strategies","volume":"20","author":"Kim","year":"2019","journal-title":"Korean J Radiol"},{"key":"2024012016250779300_ytae006-B3","first-page":"271","article-title":"Coronary artery anomalies\u2013current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines","volume":"29","author":"Angelini","year":"2002","journal-title":"Tex Heart Inst J"},{"key":"2024012016250779300_ytae006-B4","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.hlc.2017.07.014","article-title":"Coronary artery fistulae: anatomy, diagnosis and management strategies","volume":"27","author":"Buccheri","year":"2018","journal-title":"Heart Lung Circ"},{"key":"2024012016250779300_ytae006-B5","doi-asserted-by":"crossref","first-page":"W237","DOI":"10.2214\/AJR.13.11613","article-title":"Prevalence and types of coronary artery fistulas detected with coronary CT angiography","volume":"203","author":"Lim","year":"2014","journal-title":"AJR Am J Roentgenol"},{"key":"2024012016250779300_ytae006-B6","first-page":"141","article-title":"Functional assessment of a left coronary-pulmonary artery fistula by coronary flow reserve","volume":"10","author":"Sasi","year":"2014","journal-title":"Postepy Kardiol Interwencyjnej"},{"key":"2024012016250779300_ytae006-B7","doi-asserted-by":"crossref","first-page":"98","DOI":"10.2174\/1573403X15666191008100848","article-title":"Coronary fistula between left anterior descending artery (LAD) and pulmonary artery (PA) leading to sudden cardiac death: case report with literature review","volume":"16","author":"Battisha","year":"2020","journal-title":"Curr Cardiol Rev"},{"key":"2024012016250779300_ytae006-B8","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1093\/icvts\/ivt282","article-title":"Surgical treatment for coronary artery aneurysm: a single-centre experience","volume":"17","author":"Singh","year":"2013","journal-title":"Interact Cardiovasc Thorac Surg"}],"container-title":["European Heart Journal - 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