Echocardiographic detection of coronary artery fistula into the pulmonary artery

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Updated: Oct 2, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Y Yang1, T Bartel, G Caspari

  • 1Department of Cardiology, University of Essen, Germany.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|March 13, 2002
PubMed

Insights

A rare left coronary artery-pulmonary artery fistula was diagnosed. Transoesophageal echocardiography precisely identified the fistula, unlike transthoracic echocardiography, aiding diagnosis.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Coronary artery fistulas are rare congenital or acquired cardiovascular anomalies.
  • Left coronary artery-pulmonary artery fistula (LCAPAF) is an uncommon subtype requiring accurate diagnosis.

Observation:

  • A case of LCAPAF is presented.
  • Transoesophageal echocardiography (TOE) provided detailed visualization of the fistula's origin, course, and termination.
  • Transthoracic echocardiography (TTE) only detected pulmonary artery flow, lacking precise anatomical detail.

Findings:

  • TOE precisely delineated the anatomical features of the LCAPAF.
  • TTE demonstrated abnormal flow but not the fistula's complete anatomy.
  • Diagnostic accuracy for coronary artery fistulas varies between echocardiographic modalities.

Implications:

  • TOE is a valuable tool for diagnosing and excluding coronary artery fistulas.
  • Accurate anatomical characterization by TOE aids in surgical or interventional planning.
  • This case highlights the complementary roles of TTE and TOE in evaluating complex congenital heart disease.

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