Percutaneous Closure of a Large Right Coronary Artery Fistula Draining Into the Superior Vena Cava

Coronary fistulas exhibit considerable anatomic diversity, resulting in unique implications and treatment approaches.

A 38-year-old man with palpitations, chest pain, and dizziness was diagnosed with a large coronary fistula connecting the proximal right coronary artery to the superior vena cava. Percutaneous occlusion was chosen to alleviate symptoms and elevated right-sided filling pressures. After angiotomographic and angiographic evaluation, vascular plugs were selected because of the large caliber of the fistula.

This case highlights that although rare, coronary fistulas can cause significant clinical repercussions, and their management must be based on a comprehensive assessment of both clinical and anatomic factors.

Coronary fistulas can cause significant symptoms and clinical repercussions, which warrant an evaluation for occlusion. The management of coronary fistulas requires a multidisciplinary heart team discussion to select the optimal treatment based on precise clinical and anatomic considerations.