Abstract
Coronary artery fistula (CAF) is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD) stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA). CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment options.
Highlights
Coronary artery fistulas between the left anterior descending coronary (LAD) and the pulmonary artery (PA) are rare congenital malformations; concomitant significant coronary artery stenosis can cause coronary steal phenomenon and this results in myocardial ischemia [1].2
Coronary angiography revealed severe atherosclerotic coronary artery disease associated with an LAD-PA fistula (Figure 1)
The patient underwent coronary artery bypass grafting through a sternotomy in May 2011, without cardiopulmonary bypass
Summary
Coronary artery fistulas between the LAD and the PA are rare congenital malformations; concomitant significant coronary artery stenosis can cause coronary steal phenomenon and this results in myocardial ischemia [1]
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