Coronary artery fistulae

Coronary artery fistulae (CAF) are rare congenital or acquired in which a connection forms between one of the coronary arteries and a heart chamber or with other vessels. This paper describes three cases of CAF along with their initial presentation, imaging findings and management. The first case is a rare form of CAF in which the left circumflex coronary artery fistula empty into left ventricle. We discuss the different types of CAF along with their prevalence and the different imaging tools that could be utilized to identify CAF. There is no unifying consensus on treatment strategy for symptomatic fistulae and we proposed a management algorithm that could be used to make a decision for intervention versus observation. We discuss options for intervention- surgical, catheter-based and medical therapy.