E. Bernardi
Pre-operative optimization of cardiovascular conditions in patients awaiting renal transplantation significantly improves post-transplantation cardiac complications. We describe a case of symptomatic coronary fistula treated with percutaneous coil embolization in a young adult awaiting renal transplantation. A 28-year-old male presented for a pre-operative assessment in preparation for renal transplantation (RT). He reported intermittent exertional chest pain for the last 6 months. Vital signs were within normal limits and physical examination findings were remarkable only for an arteriovenous dialysis fistula. He had a history of medullary cystic kidney disease type 1 complicated by end-stage renal disease requiring hemodialysis for the previous 6 years. A regadenoson nuclear stress test result revealed a moderate zone of inferior wall myocardial ischemia. Coronary angiography revealed a right-dominant system with a large coronary artery fistula (CAF) originating from the conus branch of the right coronary artery with a superior take-off to the pulmonary artery Angiography did not demonstrate coronary artery disease. It was decided to pursue percutaneous coil embolization of the CAF.
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