Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 12, Number 10, October 2021, pages 411-414

Iatrogenic Arteriovenous Fistula Secondary to Coronary Artery Dissection Caused by Contrast Injection Into a Chronically Occluded Right Coronary Artery


Figure 1.
Figure 1. Contrast injection into the right coronary artery causing dissection at the location of the chronic total occlusion that progressed distally. Arrow indicates contrast within the right coronary artery dissection.
Figure 2.
Figure 2. Subsequent contrast injection into the right coronary artery leading to progression of the coronary dissection distally and the development of a right coronary artery-to-middle cardiac vein fistula (green arrow) which empties into the right atrium (orange arrow).


Table 1. Prior Published Case Reports of Iatrogenic CAVF and CCF Including Location and Etiology of the Fistula
StudyLocation of CAVF/CCFCause of CAVF/CCF
CAVF: coronary arteriovenous fistula; CCF: coronary cameral fistula; PCI: percutaneous coronary intervention; CTO: chronic total occlusion.
Ohayon et al, 2020 [6]Left anterior descending artery to left ventriclePrimary PCI for an anterior ST-elevation myocardial infarction
Kobayashi et al, 2012 [9]Septal artery to the right ventricleRetrograde CTO PCI
Park et al, 2012 [7]Left circumflex artery to the posterior vein of the left ventricleGuidewire-induced during CTO PCI
Narasimhan et al, 2013 [2]Circumflex artery to the coronary sinusCTO PCI induced coronary dissection of the circumflex artery
Banerjee et al, 2016 [8]Posterior descending coronary artery to the right ventricleGuidewire-induced during PCI of the right coronary artery