Bilateral Coronary Artery Fistula

Abraham Speedie1, Cinosh Mathew2, Rashmi Kerr2

  • 1Senior Resident.

Insights

Bilateral coronary artery fistulae (CAF), a rare congenital anomaly, can coexist with significant coronary artery disease. This case highlights successful percutaneous coronary intervention for managing these complex cardiac conditions.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Coronary artery fistulae (CAF) are uncommon congenital abnormalities involving abnormal connections between coronary arteries and heart chambers or great vessels.
  • These fistulae bypass the myocardial capillary bed, potentially leading to myocardial ischemia.
  • Bilateral CAF represents a rare variant of this condition.

Observation:

  • The study presents a rare case of bilateral coronary artery fistula.
  • The patient experienced angina symptoms, indicative of myocardial ischemia.
  • Significant coronary artery disease was also identified concurrently.

Findings:

  • The case demonstrates the coexistence of bilateral CAF with severe coronary artery disease.
  • Percutaneous coronary intervention was successfully employed as a treatment strategy.
  • This intervention addressed both the fistula and the obstructive coronary lesions.

Implications:

  • This case underscores the importance of considering coronary artery anomalies in patients presenting with angina and coronary disease.
  • Successful percutaneous coronary intervention can be a viable treatment option for complex cases involving bilateral CAF and significant CAD.
  • Further research into the management of rare coronary artery anomalies is warranted.

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