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Coronary fistula to the left ventricle: assessed by computed tomography

Roberto Moreno Mendonça1, Rodrigo Lima Bandeira, Fredson J S Fonseca

  • 1Instituto de Radiologia de Natal, RN, Brasil. moreno@natal.digi.com.br

Arquivos Brasileiros De Cardiologia
|November 30, 2011
PubMed

Insights

Coronary artery fistulas are rare vascular anomalies. This case highlights computed tomography angiography

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Radiology

Background:

  • Coronary artery fistulas (CAFs) are uncommon congenital or acquired abnormal connections between a coronary artery and a heart chamber or vessel.
  • Diagnosis typically involves echocardiography or cine-angiocardiography, but computed tomography angiography (CTA) is increasingly utilized.
  • While CAFs commonly drain into right heart chambers, fistulas to the left ventricle are exceptionally rare.

Observation:

  • A 46-year-old male presented with positive exercise test for ischemia.
  • Coronary CTA was performed to evaluate for obstructive coronary artery disease.
  • The CTA revealed an incidental finding of a coronary artery fistula to the left ventricle.

Findings:

  • Computed tomography angiography successfully diagnosed a rare coronary artery fistula directly into the left ventricle.
  • The patient was asymptomatic and had no obstructive coronary artery disease.
  • This case underscores the diagnostic capability of CTA in identifying uncommon cardiac pathologies.

Implications:

  • Coronary CTA is a valuable tool for diagnosing rare coronary artery anomalies like fistulas to the left ventricle.
  • Early diagnosis and characterization of coronary fistulas are crucial for appropriate management, which can be surgical or percutaneous.
  • This case expands the understanding of CAF presentations and diagnostic modalities.

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