Case report. Multiple Mediastinal Arteriovenous Fistulas in a Patient with Myocardial Ischemia Symptoms and Tachy-Brady Arrhythmias

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Arteriovenous fistulas are abnormal vascular communications between the arterial and venous system and may lead to the development of arteriovenous shunts. These malformations are extremely rare, and their diagnosis can be difficult due to the lack of symptoms or the absence of hemodynamic consequences. In many cases, arteriovenous fistulas are discovered by chance. In this brief report, we present the case of a 31-year-old male with symptoms suggestive of angina pectoris, tachycardia-bradycardia syndrome and multiple episodes of syncope. Multi-slice computed tomography revealed the presence of multiple mediastinal fistulas connecting the aorta, superior vena cava, pulmonary veins and azygos system.

1. Martinez-Jimenez S, Heyneman LE, McAdams HP, et al. Nonsurgical Extracardiac Vascular Shunts in the Thorax: Clinical and Imaging Characteristics. RadioGraphics. 2010;10.1148/rg.e41.

2. Martinez-Jimenez S, Heyneman LE, McAdams HP, et al. The science and practice of pediatric cardiology. Radiographics. 2010;30:e41. doi:

3. Sapire DW, Lobe TE, Swischuk LE, Casta A, Schwartz MZ, Droge M. Subclavian-artery-to-innominate-vein fistula presenting with congestive failure in a newborn infant. Pediatr Cardiol. 1983;4:155-157.

4. Ghandour A, Partovi S, Karuppasamy K, Rajiah P. Congenital anomalies of the IVC - embryological perspectives and clinical relevance. Cardiovasc Diagn Ther. 2016;6:482-492. doi:

5. Romero FD, Fernández EM, Albelo TP, González HV, Gonzalez IA. Congenital aorto-azygous fistula treated with coil embolization: case report and review of the literature. Cardiovasc Intervent Radiol. 2006;29:907-910. doi:

6. Soler P, Mehta AV, Garcia OL, Kaiser G, Tamer D. Congenital systemic arteriovenous fistula between the descending aorta, azygos vein, and superior vena cava. Chest. 1981;80:647-649.

7. Recto MR, Elbl F. Transcatheter Coil Occlusion of a Thoracic Arteriovenous Fistula in an Infant with Congestive Heart Failure. Tex Heart Inst J. 2001;28:119-121.

8. Doig JC, Saito J, Harris L, Downar E. Coronary sinus morphology in patients with atrioventricular junctional reentry tachycardia and other supraventricular tachyarrhythmias. Circulation. 1995;92:436-441.

9. Benson R, Songrug T. CT appearance of persistent left superior vena cava, anomalous right superior pulmonary venous return into the right sided superior vena cava and a sinus venosustype atrial septal defect. Br J Radiol. 2009;82:e235-e239. doi:

10. Anderson JH, Wallace S, Gianturco C. Transcatheter intravascular coil occlusion of experimental arteriovenous fistulas. AJR Am J Roentgenol. 1977;129:795-798.

11. Bricelj V, Robida A. Coil occlusion of arteriovenous fistula of the vertebral artery in a child. Cathet Cardiovasc Diagn. 1998;43:434-437.

12. Ebeid MR, Braden DS, Gaymes CH, Joransen JA. Closure of a large pulmonary arteriovenous malformation using multiple Gianturco-Grifka vascular occlusion devices. Cathet Cardiovasc Interv. 2000;49:426-429.

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