Abstract
One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF). 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. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD) artery to the left ventricular (LV) apex. Associated cardiac abnormalities were found: a ventricular septal defect (diameter 4 mm), a patent foramen ovale as well as trivial tricuspid and mitral regurgitation. Here we demonstrate the echocardiograms of an extremely rare form of CAF diagnosed within the first days of postnatal life.
Highlights
Normal coronary artery anatomy is characterized by two ostia placed centrally in the right and left sinus of Valsalva
We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD) artery to the left ventricular (LV) apex
One of the primary forms is coronary artery fistula (CAF), that are defined as a direct communication of a coronary artery with a cardiac chamber, great vessel or other vascular structure, bypassing the myocardial capillary bed
Summary
Significant congenital anomalies of coronary arteries are shown in Table 1[2]. One of the primary forms is coronary artery fistula (CAF), that are defined as a direct communication of a coronary artery with a cardiac chamber, great vessel or other vascular structure, bypassing the myocardial capillary bed. These fistulae seem to represent persistent junctions of primordial epicardial vessels with intramyocardial sinusoidal circulation. Due to the risk for ischemia secondary to steal from the coronary fistula, daily electrocardiograms were obtained after admission to the cardiovascular intensive care unit (CVICU) for monitoring. The child was discharged home on day 8 without any complications on diuretic therapy and monitored closely on an ambulant manner as an attempt for conservative therapy on request of the parents
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