[Coronary fistula in adults. Review with reference to personal experience]

A consecutive series of 5384 coronary arteriograms was retrospectively investigated for the presence of coronary artery fistulas. 15 fistulas were found in 14 patients, corresponding to a prevalence of 0.26%. All the fistulas were small and hemodynamically insignificant. There were no fistula-associated complications. Most of the fistulas were discovered as incidental findings during an otherwise indicated coronary angiography (8 patients). In the 6 patients without other cardiac pathology, the investigation was performed because of a systolo-diastolic murmur in 2 cases, myocardial ischemia caused by a "coronary-steal phenomenon" in 2 cases, and chest pain in 2 cases. With the exception of a fistula between two coronary arteries and a postoperative fistula, all of them originated from the proximal part of the coronary arteries (9 from the right, 6 from the left). Most of the fistulas drained into the main pulmonary artery (73%).