An unusually large coronary-cameral fistula - A case report

Coronary artery fistula is a rare malformation causing abnormal coronary-cameral communications. While the course of this pathology may be benign in early childhood, the symptoms of the disease intensify with age and can eventually cause serious complications, even sudden death. This report details our treatment of a 32-year-old female who had minor cardiac symptoms and was diagnosed with a substantial coronary-cameral fistula originating from the right sinus of Valsava and draining into the posterobasal area of the left ventricle. The diagnosis was made using transthoracic and transesophageal echocardiograms and confirmed by cardiac catheterization. Because of the fistula's atypically large size (1.8 cm in diameter) and significant flow that was causing left ventricle dilatation and borderline left ventricular performance (ejection fraction 50%), the patient received elective surgical closure and became asymptomatic. A follow-up echocardiogram a year later showed that her ventricular size and function had returned to normal.