[Primary coronary artery fistula]

Area of Science:

• Cardiology
• Congenital Heart Disease
• Vascular Malformations

Background:

• Congenital coronary artery fistulas are rare anomalies.
• They can present with varied clinical manifestations.
• Diagnosis often requires advanced imaging techniques.

Observation:

• A primary congenital coronary artery fistula was identified.
• The fistula exhibited a left-to-right shunt.
• The shunt directed blood flow into the coronary sinus.

Findings:

• The patient was a 71-year-old female.
• Supravalvular aortography provided definitive angiographic evidence.
• This confirmed the fistula's origin and drainage pattern.

Implications:

• This case highlights the potential for late presentation of congenital coronary artery fistulas.
• Understanding shunt patterns is crucial for management.
• Supravalvular aortography is a valuable diagnostic tool for coronary artery anomalies.