Coronary artery-left ventricular fistulae with atrial septal defect

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiovascular Surgery

Background:

• Coronary artery fistulas are abnormal connections between a coronary artery and a heart chamber or great vessel.
• While coronary artery fistulas associated with cardiac valve anomalies are documented, their co-occurrence with specific types of atrial septal defects is rare.
• Sinus venosus atrial septal defects are a less common form of congenital heart defect affecting the upper part of the atrial septum.

Observation:

• A 65-year-old female patient presented with symptoms of left-sided heart failure.
• Diagnostic imaging revealed a coronary artery-left ventricular fistula.
• The fistula was found in conjunction with an atrial septal defect of the sinus venosus type.

Findings:

• This case represents the first reported instance of a coronary artery-left ventricular fistula associated with a sinus venosus atrial septal defect.
• The patient's clinical presentation of left-sided heart failure was attributed to this complex cardiac anomaly.
• The co-existence of these two distinct congenital and acquired cardiac conditions highlights a unique pathological scenario.

Implications:

• This finding expands the known spectrum of cardiac anomalies associated with coronary artery fistulas.
• Understanding this association is crucial for accurate diagnosis and tailored treatment strategies in patients with complex congenital heart disease.
• Further research may elucidate the embryological or pathophysiological mechanisms linking these conditions, potentially improving clinical management and patient outcomes.