Right coronary artery fistula to left ventricle complicated with huge coronary artery aneurysm

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Imaging

Background:

• Congenital coronary artery fistula (CAF) is a rare condition.
• Huge coronary artery aneurysms associated with CAF are exceptionally rare.
• This case highlights a unique presentation of a right coronary artery (RCA) to left ventricle fistula with a giant aneurysm.

Observation:

• A 26-year-old asymptomatic male presented with a rare congenital coronary artery fistula.
• Diagnosis was confirmed using multidetector computed tomography and coronary angiography.
• The patient had a significant aneurysm of the right coronary artery.

Findings:

• Surgical intervention included excision of the RCA and the giant aneurysm.
• The fistula was surgically closed, and coronary artery bypass grafting was performed.
• Post-surgery echocardiography showed normalization of the enlarged left ventricle within two months.

Implications:

• This case demonstrates the successful surgical management of a rare congenital coronary anomaly.
• Early diagnosis and surgical treatment are crucial for favorable outcomes.
• Effective surgical strategies can reverse cardiac remodeling in patients with coronary artery fistulas and aneurysms.