A Case of Coronary Cameral Fistula: When and How to Intervene?

Mehdi Peighambari; Marziyeh Pakbaz; Azin Alizadehasl; Saeid Hosseini; Hamidreza Pouraliakbar

doi:10.18502/jthc.v15i4.5946

Mehdi Peighambari Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Marziyeh Pakbaz Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Azin Alizadehasl Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Saeid Hosseini Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Hamidreza Pouraliakbar Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v15i4.5946

Keywords: Heart Defects, Congenital; Fistula; Computed tomography angiograph

Abstract

Coronary artery fistulas constitute a rare anomaly defined as an abnormal communication between a coronary artery and a great vessel or any cardiac chamber. The majority of these fistulas arise from the right coronary artery and the left anterior descending coronary artery; the circumflex coronary artery is rarely involved. We present an unusual case of a coronary artery fistula in a middle-aged woman who presented with symptoms of heart failure and abnormal auscultation. Echocardiography and conventional and computed tomography angiography showed that the coronary fistula originated from the left circumflex coronary artery and drained majorly into the right ventricle. Given the complex anatomy of the fistula, we managed it surgically rather than percutaneously. There were no complications early after surgery and at 1 year’s follow-up.