RT Journal Article
SR Electronic
T1 Rare case of congenital coronary artery fistula coexistent and coalesced with aortopulmonary fistula
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e244035
DO 10.1136/bcr-2021-244035
VO 14
IS 7
A1 Takumi Osawa
A1 Yuta Ito
A1 Tomomi Koizumi
YR 2021
UL http://casereports.bmj.com/content/14/7/e244035.abstract
AB Coronary artery fistula (CAF) is an uncommon congenital heart disease. Furthermore, aortopulmonary fistula is a rare congenital heart disease of adult onset. We report the case of a 79-year-old man who presented with chest pain. ECG-gated cardiac CT and coronary artery angiography revealed an anomalous vessel arising from the right coronary cusp and a CAF from the left coronary descending artery. These fistulas coalesced and drained into the same portion of the pulmonary artery. Haemodynamic studies revealed that the estimated systemic-to-pulmonary flow ratio was 1.18. The mean pulmonary pressure was 14 mm Hg. We decided against surgical intervention due to his advanced age and lack of heart failure symptoms. The patient did not have any worsening heart failure and chest pain on follow-up. This was a rare case of CAF coexistent and coalesced with an aortopulmonary fistula.