Aortocoronary arteriovenous fistula (ACAVF) due to iatrogenic bypass grafting to a cardiac vein is an exceedingly rare complication resulting from coronary artery bypass grafting (CABG) surgery. If not identified in a timely fashion, ACAVF has known significant clinical consequences related to left to right shunting and possible residual myocardial ischemia. An 82-year-old male with a history of CABG, presented with dyspnea. Over the span of 2 years following CABG, the patient experienced progressive exertional dyspnea and peripheral edema. The patient was found to have a new cardiomyopathy with a severely reduced ejection fraction at 30–35%. The patient underwent diagnostic left heart catheterization, and an ACAVF was discovered between a saphenous vein graft and the coronary sinus. The patient underwent successful percutaneous coiling of the ACAVF with no residual flow. Follow-up echocardiography at 3 months revealed restoration of left ventricular systolic function to 50% and significant improvement in heart failure symptoms. ACAVF is an exceedingly rare iatrogenic complication of CABG that may result in residual ischemia from the non-grafted myocardial territory and other sequelae relating to left to right shunting and a high-output state. Management for this pathology includes but is not limited to the use of percutaneous coiling, implantation of covered stents, graft removal and regrafting, and ligation.

中文翻译：

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病例报告：经皮治疗医源性主动脉冠状静脉移植至冠状窦引起的高输出量心力衰竭

由于医源性心脏静脉旁路移植术引起的主动脉冠状动静脉瘘 (ACAVF) 是冠状动脉旁路移植术 (CABG) 手术引起的极为罕见的并发症。如果没有及时发现，ACAVF 会产生与左向右分流和可能的残余心肌缺血相关的重大临床后果。一名 82 岁男性，有 CABG 病史，因呼吸困难就诊。在 CABG 后的 2 年内，患者经历了进行性劳力性呼吸困难和外周水肿。该患者被发现患有新的心肌病，射血分数严重降低 30-35%。患者接受了诊断性左心导管插入术，在大隐静脉移植物和冠状窦之间发现了 ACAVF。患者成功地对 ACAVF 进行了经皮盘绕，没有残余血流。3 个月时的随访超声心动图显示左心室收缩功能恢复至 50%，心力衰竭症状显着改善。ACAVF 是 CABG 的一种极为罕见的医源性并发症，可能导致非移植心肌区域的残余缺血和其他与左向右分流和高输出状态相关的后遗症。这种病理的处理包括但不限于使用经皮弹簧圈、植入覆膜支架、移植物移除和再移植以及结扎。ACAVF 是 CABG 的一种极为罕见的医源性并发症，可能导致非移植心肌区域的残余缺血和其他与左向右分流和高输出状态相关的后遗症。这种病理的处理包括但不限于使用经皮弹簧圈、植入覆膜支架、移植物移除和再移植以及结扎。ACAVF 是 CABG 的一种极为罕见的医源性并发症，可能导致非移植心肌区域的残余缺血和其他与左向右分流和高输出状态相关的后遗症。这种病理的处理包括但不限于使用经皮弹簧圈、植入覆膜支架、移植物移除和再移植以及结扎。