fistllia eallsed hy ellfTed traehealtllhes.
1973; 6.'5:612-19
J Thorae Cardiovase Surg
.'5 (;rillo IIC, Monellrt· AC, MeEnany MT Hepair of inflammatory traeht·(H.·sophagt·al fistllia. Ann Thorae SlIrg 1976; 22: 112-19 6 Bartlett HII. A pnH.·edllre for management of aeCJnired traeheot'sophageal fistula in ventilator patients. J Thorac Cardiovasc Surg
1976; 7 U19-9.'5 7 Utley JH, Dillon ML. lIKid Ep, Griffen WOo 7A'ok JV Giant traeheoesophageal fistula: managt'ment hy esophageal diversion.
J Thorac Cardiovase Surg 1978; 7.'5:373-77
I> Orringer MG, Sloan II. Anterior mediastinal tradlt'ostomy: imlit'ations. tt·chniCJlIes. and dinit'al experience. J Thorae Cardiovase Surg 1979; 71>:1>.'50-.'59
Coronary Artery Fistula Formation secondary to Permanent Pacemaker Placement· Koomllsh Sade"., M./J.;t nllwthy \Hlinga, M.D.;t /tIllITrollP, III./J.;+ ami Jllle' Wet!tal}(,l!. M./J.§
FU:l'In: I. Coronary arlc'ry fislllia originating fro," septal arlc'ry and eOllllllllnieating with right H'ntride aflt'r plae"n)('lIt of pan'lIIakt'r It'ad (east· 2).
We present the findings in two patients who apparently developed a coronary artery fistula as a complication of an endocardial pacing electrode. This complication may actually be occurring more frequently than recognized because the patient may be asymptomatic or minimally symptomatic and therefore not undergo a coronary angiogram. Awareness of this potentially serious complication is important and stresses the need for proper electrode placement without excess pressure on the tip. (Chest 1991; 99:780-81)
lip to 2.2 s"eonds long. A tranSH'IIOIlS hipolar pennanent tilled pacing eleelrode (I II lc'rllled it's. I.·ad 476-()\; tlm·shold. 0.6 V) was passed into the right n~ntrit'ular ap"x undt'r f1l1oroseopit' gllidanee with no eOlllplieations. Fiflt"'n lIIonths lalt'r, the patient was hospitalized ft,r "valuation of lIt·w allterolalt'ral Sl:seglnellt depressiool and T-wan' inH·rsion. TIlt' physit'al exalllillatioll d"lIIonstrated an SI and a gradt' 2/6 systolit' munllur heard at tilt' apt'x without radiation. Cardiae eathekrization and eoronary angiography were perfi>rJued. Hight heart prt'ssllres ami eardiae index wert· normal. Angiography revealed dillilsely irregular t'lronary arkri.·s, hut th(-&rt., was IIC) significant stellosis. A (Ooronary artery fistula was seen t'lursing from the distal I..ft anterior d"sn'ndiug artery 10 th.. right vt'ntride adjan'nt to thl' right ventrieular paeing Il'ad. Thl' apieal location of the pal'emaker lead was \'('rified via f1uoroSt'lpy. and a dwek of the paeemak"r demousl ral4 6 (;iII.. hert C. Vaulloof H. \i'nD.·\\.... r. Pi,'sst'ns j. D..C..est II. Coronary arl
1973; 6.'5:612-19
J Thorae Cardiovase Surg
.'5 (;rillo IIC, Monellrt· AC, MeEnany MT Hepair of inflammatory traeht·(H.·sophagt·al fistllia. Ann Thorae SlIrg 1976; 22: 112-19 6 Bartlett HII. A pnH.·edllre for management of aeCJnired traeheot'sophageal fistula in ventilator patients. J Thorac Cardiovasc Surg
1976; 7 U19-9.'5 7 Utley JH, Dillon ML. lIKid Ep, Griffen WOo 7A'ok JV Giant traeheoesophageal fistula: managt'ment hy esophageal diversion.
J Thorac Cardiovase Surg 1978; 7.'5:373-77
I> Orringer MG, Sloan II. Anterior mediastinal tradlt'ostomy: imlit'ations. tt·chniCJlIes. and dinit'al experience. J Thorae Cardiovase Surg 1979; 71>:1>.'50-.'59
Coronary Artery Fistula Formation secondary to Permanent Pacemaker Placement· Koomllsh Sade"., M./J.;t nllwthy \Hlinga, M.D.;t /tIllITrollP, III./J.;+ ami Jllle' Wet!tal}(,l!. M./J.§
FU:l'In: I. Coronary arlc'ry fislllia originating fro," septal arlc'ry and eOllllllllnieating with right H'ntride aflt'r plae"n)('lIt of pan'lIIakt'r It'ad (east· 2).
We present the findings in two patients who apparently developed a coronary artery fistula as a complication of an endocardial pacing electrode. This complication may actually be occurring more frequently than recognized because the patient may be asymptomatic or minimally symptomatic and therefore not undergo a coronary angiogram. Awareness of this potentially serious complication is important and stresses the need for proper electrode placement without excess pressure on the tip. (Chest 1991; 99:780-81)
lip to 2.2 s"eonds long. A tranSH'IIOIlS hipolar pennanent tilled pacing eleelrode (I II lc'rllled it's. I.·ad 476-()\; tlm·shold. 0.6 V) was passed into the right n~ntrit'ular ap"x undt'r f1l1oroseopit' gllidanee with no eOlllplieations. Fiflt"'n lIIonths lalt'r, the patient was hospitalized ft,r "valuation of lIt·w allterolalt'ral Sl:seglnellt depressiool and T-wan' inH·rsion. TIlt' physit'al exalllillatioll d"lIIonstrated an SI and a gradt' 2/6 systolit' munllur heard at tilt' apt'x without radiation. Cardiae eathekrization and eoronary angiography were perfi>rJued. Hight heart prt'ssllres ami eardiae index wert· normal. Angiography revealed dillilsely irregular t'lronary arkri.·s, hut th(-&rt., was IIC) significant stellosis. A (Ooronary artery fistula was seen t'lursing from the distal I..ft anterior d"sn'ndiug artery 10 th.. right vt'ntride adjan'nt to thl' right ventrieular paeing Il'ad. Thl' apieal location of the pal'emaker lead was \'('rified via f1uoroSt'lpy. and a dwek of the paeemak"r demousl ral4 6 (;iII.. hert C. Vaulloof H. \i'nD.·\\.... r. Pi,'sst'ns j. D..C..est II. Coronary arl
