Right coronary artery–to-right ventricle fistula complicating percutaneous transluminal angioplasty: case report and review of the literature Piotr Lipiec,

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Right coronary artery–to-right ventricle fistula complicating percutaneous transluminal angioplasty: case report and review of the literature Piotr Lipiec, MD, Jan Z Peruga, MD, PhD, Maria Krzemińska-Pakula, MD, PhD, Jakub Foryś, MD, Jaroslaw Drozdz, MD, PhD, Jaroslaw D Kasprzak, MD, PhD Journal of the American Society of Echocardiography Volume 17, Issue 3, Pages 280-283 (March 2004) DOI: 10.1016/j.echo.2003.10.012

Figure 1 Right coronary angiograms before (A) and after (B and C) angioplasty. A, Right anterior oblique view demonstrating disseminated lesions with 95% stenosis in proximal right coronary artery (RCA) (arrow) and occlusion in distal part of RCA with delayed retrograde filling by collaterals. B, Large aneurysmal dilatation (arrow) of distal RCA. C, Stream of contrast flowing from distal RCA into cardiac chamber (arrows). Journal of the American Society of Echocardiography 2004 17, 280-283DOI: (10.1016/j.echo.2003.10.012)

Figure 2 Modified apical 2-chamber echocardiographic view. A, Aneurysmal distal part of right coronary artery (RCA) (6-mm diameter) (arrows). B, Flow between distal part of RCA and right ventricle (RV) visualized by Doppler color flow mapping (arrow) clearly indicates presence of RCA-to-RV fistula. C, Phasic flow in RCA-to-RV fistula recorded with pulsed Doppler; diastolic component of flow (arrow). IVS, Interventricular septum; LV, left ventricle. Journal of the American Society of Echocardiography 2004 17, 280-283DOI: (10.1016/j.echo.2003.10.012)

Figure 3 Apical 2-chamber view. Comparison of end-diastolic (left) and end-systolic (right) phases demonstrates hypokinetic basal segments of inferior wall (arrows). Journal of the American Society of Echocardiography 2004 17, 280-283DOI: (10.1016/j.echo.2003.10.012)