Key result
Closed mitral valvotomy resulted in an acquired coronary artery to pulmonary vein arteriovenous fistula presenting as left ventricular failure 21 years after the procedure.
This case report highlights the rare possibility of an acquired coronary arteriovenous fistula developing decades after cardiac surgery trauma.
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May prompt consideration of iatrogenic fistulas in late post-valvotomy LV failure; extends known sequelae but remains hypothesis-generating.
A patient is described who underwent closed mitral valvotomy and presented 21 years later with left ventricular failure. Coronary angiography revealed a coronary artery to pulmonary vein arteriovenous fistula. This is the first report of an acquired fistula of this type developing secondary to trauma associated with cardiac surgery. Diagnosis and treatment implications are discussed.
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Pattee et al. (1992) studied this question. Closed mitral valvotomy resulted in an acquired coronary artery to pulmonary vein arteriovenous fistula presenting as left ventricular failure 21 years after the procedure.
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