Gigantic arteriovenous fistula between left coronary cusp and coronary sinus draining into the right atrium

Area of Science:

• Cardiology
• Radiology
• Anatomical Pathology

Background:

• Coronary arteriovenous fistulas (CAF) are rare congenital anomalies with an incidence of 0.002%.
• These fistulas create abnormal direct connections between the coronary arteries and cardiac chambers.
• CAF originating from the left coronary artery are exceptionally uncommon.

Purpose of the Study:

• To report a rare case of a gigantic coronary arteriovenous fistula.
• To discuss the incidental diagnosis and management of an asymptomatic patient with CAF.
• To highlight the role of advanced imaging in detecting rare cardiac anomalies.

Main Methods:

• Incidental detection of a gigantic CAF using low-dose Computed Tomography (CT) scan of the chest.
• Multidisciplinary consultation with cardiothoracic surgeons for case review.
• Recommendation for conservative medical management and close surveillance.

Main Results:

• A middle-aged, asymptomatic male patient was diagnosed with a gigantic CAF.
• The fistula was incidentally discovered during a routine low-dose CT scan.
• Conservative management with ongoing surveillance was advised by specialists.

Conclusions:

• Asymptomatic, incidentally discovered gigantic CAF can be managed conservatively with close monitoring.
• Low-dose CT imaging is effective in identifying rare cardiac anomalies like CAF.
• Further research may lead to novel, less invasive therapeutic options for CAF.