Related Experiment Video
Updated: Apr 26, 2026
Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Angiographic characteristics of coronary artery fistulas
Cemal Tuncer1, Beyhan Eryonucu2, Talantbek Batyraliev3
1Department of Cardiology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey.
Insights
Coronary artery fistula (CAF) is a rare anomaly, found in 0.08% of adult angiograms. The most common origin is the left anterior descending artery, often presenting with dyspnea or angina.
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Imaging
Background:
- Coronary artery fistula (CAF) is an uncommon congenital or acquired anomaly of the heart's vasculature.
- CAFs are often incidentally discovered during diagnostic coronary angiography in adult patients.
- Understanding the clinical and angiographic features of CAF is crucial for appropriate management.
Purpose of the Study:
- To determine the prevalence of CAF in an adult population undergoing coronary angiography.
- To characterize the clinical presentation and symptoms associated with CAF.
- To identify the common anatomical origins and drainage patterns of CAFs.
Main Methods:
- Retrospective analysis of 70,850 coronary angiograms from five centers in southeastern Turkey.
- Inclusion of 56 adult patients diagnosed with CAF.
- Review of demographic data, clinical evaluations, and cardiac catheterization reports.
Main Results:
- CAF prevalence was 0.08% (56 patients with 58 fistulas).
- Dyspnea and/or angina were the most frequent symptoms (69%).
- The left anterior descending artery was the most common origin (51.7%), with 26.8% having coexisting obstructive coronary artery disease.
Conclusions:
- The prevalence of CAF in this adult cohort was 0.08%.
- The left anterior descending artery is the primary source of coronary artery fistulas.
- CAF diagnosis requires careful angiographic evaluation due to potential coexisting coronary artery disease.
Objectives:
Coronary artery fistula (CAF) in adults is a rare form of coronary artery anomaly. It is often diagnosed incidentally during coronary angiography. The aim of this study was to evaluate the clinical and angiographic characteristics of adult patients with CAF.
Study Design:
We retrospectively reviewed the database of 70,850 patients who had undergone coronary angiography in five different invasive cardiology centers in the southeastern region of Turkey. Among them, 56 patients had CAF (39 males, 17 females, mean age: 63.7±10.4 years). Demographic data, clinical evaluation and cardiac catheterization reports were reviewed from the medical records.
Results:
A total of 58 fistulas were detected in 56 patients; two patients (3.6%) had bilateral fistulas originating from both the left and right coronary artery. In our angiographic series, CAF prevalence was 0.08%. Dyspnea on exertion and/or angina pectoris was the most common symptom (69%). Fifteen patients (26.8%) had concomitant obstructive coronary artery disease. Coronary artery fistulas originated mainly from the left anterior descending artery (n=30, 51.7%). Others originated from the right coronary artery (n=15, 25.9%), circumflex artery (n=6, 10.3%), and right sinus of Valsalva (n=3, 5.2%). In four patients (n=4, 7.1%), multiple micro fistula were draining into the left ventricle.
Conclusion:
In our angiographic series, the prevalence of CAF was 0.08%, and the most common site of origin was the left anterior descending artery.
Related Concept Videos
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
01:30Aneurysm I: Introduction