Congenital Coronary Artery Fistulas: Report of Three Rare Cases

Coronary artery fistula is a rare congenital anomaly with an incidence of about 0.2 - 0.6% in different reports. It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure which bypasses the myocardial capillary bed. Three interesting cases of coronary artery fistula are reported. Two of the patients were symptomatic. In one case, all coronary arteries (in addition to duplicated LAD) were fistulized into the right ventricle. Diagnosis was made by echocardiographic study and coronary angiography. Surgical correction is discussed. In one case, angiography six months later showed no fistula. Serial echocardiography during follow-up was unremarkable (Iranian Heart Journal 2008; 9 (1):64 -68).