Coronary Artery Fistulae Involving Both Right and Left Coronary Arteries

A coronary artery fistula is defined as an abnormal direct communication between any coronary artery and any of the cardiac chambers, superior vena cava, coronary sinus, pulmonary artery, and pulmonary veins. The right coronary artery (RCA) is the most common site of origin, and right heart chambers are the most common site of drainage. However, there are few cases reported in the literature in which the fistulae originate from both the right coronary and the left anterior descending arteries and drain into the pulmonary artery. We present a case with fistulae involving both right and left coronary arteries.