Aneurysmal coronary cameral fistula

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Imaging

Background:

• A 26-year-old male with a history of ventricular septal defect presented for evaluation.
• He was asymptomatic with normal vital signs but had a diastolic murmur.

Observation:

• Transthoracic echocardiography revealed diastolic flow from the left ventricular anteroseptal wall into the left ventricular cavity.
• Multidetector CT confirmed a coronary-cameral fistula involving an aneurysmal left anterior descending artery to the left ventricle.

Findings:

• Diagnosis of a large coronary-cameral fistula (2.5x2 cm) originating from the left anterior descending artery and draining into the left ventricle.
• Potential risks included thrombus formation and systemic embolization.

Implications:

• Transcatheter closure was considered but declined by the patient.
• The patient remained asymptomatic at 1-year follow-up, highlighting potential for conservative management in select cases.
• This case underscores the importance of advanced imaging in diagnosing rare cardiac anomalies.