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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Bilateral Epicardial Coronary Microfistulas With Anomalous Deviation

João Cleriston da Silva Calheiros1, João Pedro Kern Alves2, Natan Lucca Lima2

  • 1Department of Medical Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil; University of the Extreme South of Santa Catarina, Criciúma, Santa Catarina, Brazil; Department of Cardiology, São José Hospital, Criciúma, Santa Catarina, Brazil; Emergency Department, São João Batista Hospital, Criciúma, Santa Catarina, Brazil.

JACC. Case Reports
|January 30, 2026
PubMed

Insights

Bilateral coronary microfistulas draining into the left ventricle are rare and can cause type 2 myocardial infarction. Coronary angiography is key for diagnosis and conservative management is important.

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Bilateral coronary microfistulas redirecting flow to the left ventricle are exceptionally rare.
  • While often asymptomatic, severity varies, potentially causing type 2 myocardial infarction.
Abstract

Keywords:
case reportcoronary artery fistulacoronary vessel anomaliesmicrofistulas

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