{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:05:57Z","timestamp":1790355957845,"version":"4.1.0"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report the case of a previously healthy 19-year-old woman with a large left coronary trunk\u2013to\u2013right atrium fistula, managed by percutaneous closure. Post-procedural antithrombotic therapy included apixaban and low-dose aspirin. One month later, the patient developed severe metrorrhagia with no identifiable organic cause, prompting unilateral modification of antithrombotic therapy without multidisciplinary discussion. Two months post-intervention, she presented with an acute ST-segment elevation myocardial infarction, likely resulting from thrombus formation at the prosthesis site. Coronary flow of the left anterior descending artery was restored by successful thromboaspiration without stenting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights that any modification of antithrombotic therapy following percutaneous fistula closure must result from a thorough multidisciplinary discussion, carefully balancing bleeding risk against the potentially fatal consequences of thromboembolic events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag668","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:38:36Z","timestamp":1788867516000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute coronary syndrome following percutaneous closure of a coronary artery fistula: the essential anticoagulation management\u2014a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8693-3634","authenticated-orcid":false,"given":"Servoz","family":"Cl\u00e9ment","sequence":"first","affiliation":[{"name":"Cardiology Department of Rangueil Hospital, Toulouse University Hospital, 1 av. Pr. Poulh\u00e8s, 31400 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamir","family":"El Mehdi","sequence":"additional","affiliation":[{"name":"Cardiology Department of Rangueil Hospital, Toulouse University Hospital, 1 av. Pr. Poulh\u00e8s, 31400 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruguiere","family":"Eric","sequence":"additional","affiliation":[{"name":"Congenital Cardiology Department, Clinique Pasteur , 45 av. Lombez, 31000 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5238-7791","authenticated-orcid":false,"given":"Combes","family":"Nicolas","sequence":"additional","affiliation":[{"name":"Congenital Cardiology Department, Clinique Pasteur , 45 av. Lombez, 31000 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsenty","family":"Cl\u00e9ment","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Centre Hospitalier Universitaire de Toulouse, 330 av. Grande-Bretagne , 31300 Toulouse ,","place":["France"]},{"name":"INSERM, UMR 1297, Institut des Maladies M\u00e9taboliques et Cardiovasculaires, 1 av. Pr. Poulh\u00e8s , 31400 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026092512370115800_ytag668-B1","first-page":"118","article-title":"Fistule coronaire de d\u00e9couverte fortuite dans le cadre d\u2019une cardiopathie rhumatismale: a propos d\u2019un cas et revue de la litt\u00e9rature","volume":"15","author":"Gandet","year":"2010","journal-title":"Chirurgie Thoracique Cardio Vasculaire"},{"key":"2026092512370115800_ytag668-B2","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.jcin.2021.02.044","article-title":"Coronary artery fistulas: indications, techniques, outcomes, and complications of transcatheter Fistula closure","volume":"14","author":"Al-Hijji","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2026092512370115800_ytag668-B3","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s11886-024-02038-1","article-title":"Diagnosis and management of congenital coronary artery fistulas in adults","volume":"26","author":"Kanduri","year":"2024","journal-title":"Curr Cardiol Rep"},{"key":"2026092512370115800_ytag668-B4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ijcard.2005.01.067","article-title":"Coronary artery fistulas: clinical and therapeutic considerations","volume":"107","author":"Gowda","year":"2006","journal-title":"Int J Cardiol"},{"key":"2026092512370115800_ytag668-B5","first-page":"101300","article-title":"Treatment strategies for coronary artery fistulas: a contemporary review of anatomy, diagnosis, and management","volume":"3","author":"Muhtaroglu","year":"2024","journal-title":"Heart Surg Forum"}],"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\/ytag668\/71004515\/ytag668.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/9\/ytag668\/71004515\/ytag668.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/9\/ytag668\/71004515\/ytag668.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:37:09Z","timestamp":1790354229000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag668\/8788655"}},"subtitle":[],"editor":[{"given":"Luis Antonio","family":"Moreno-Ruiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Jaime","family":"Santiago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Tarzil","family":"Necoechea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":5,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,27]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag668","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,8,27]]},"article-number":"ytag668"}}