Right pulmonary artery to left atrium fistula: transcatheter closure without conventional venovenous loop

Right pulmonary artery to left atrium fistula is a rare anatomic variation of pulmonary arteriovenous malformation in which the initial connection exists between a pulmonary artery and a pulmonary vein, but during vascular development the pulmonary vein gets incorporated into the left atrium. Though nearly 60 such cases have been reported in literature, only 6 cases have been tackled by transcatheter technique with various types of devices and coils. This is a case where we demonstrate that large fistulae can be closed successfully with an atrial septal occluder without a conventional method of transseptal puncture and venovenous loop formation.