Multiple coronary arteriovenous fistulae

Area of Science:

• Cardiology
• Congenital Heart Disease
• Vascular Malformations

Background:

• Congenital coronary arteriovenous fistulae (ccAVF) are rare anomalies.
• They represent abnormal connections between coronary arteries and cardiac chambers or great vessels.
• Understanding their diverse presentations is crucial for diagnosis and management.

Observation:

• A unique case of multiple ccAVF is presented.
• The right coronary artery communicated directly with the right ventricle.
• The left coronary artery entered the pulmonary trunk, with branches of the anterior descending artery entering the left ventricle.

Findings:

• This case exhibits multiple ccAVF with complex anatomical variations.
• A direct left coronary artery-to-pulmonary trunk communication, without intervening structures, is a novel observation.
• Multiple fistulous connections involving both coronary arteries and cardiac chambers/great vessels were identified.

Implications:

• This case expands the known spectrum of ccAVF anatomy.
• The direct left coronary artery-to-pulmonary trunk fistula represents a unique embryological or developmental pathway.
• Further investigation into such rare presentations is needed to refine understanding and treatment strategies for coronary artery anomalies.