title: Left circumflex coronary artery to left atrial fistula in a patient with mitral stenosis: invasive and noninvasive findings with pathophysiologic correlation.
abstract: We report a case of an angiographically documented fistula between the circumflex coronary artery and a left strial appendage thrombus in a patient with mitral stenosis, flow from which can be demonstrated solely by a color doppler transesophageal echocardiogram. Evaluation of catheter derived hemodynamics and angiographic flow patterns reveals a heretofore undescribed physiologic property of coronary to atrial shunts in patients with mitral stenosis.
authors.affiliation: Department of Medicine, New York Medical College, Westchester County Medical Center, Valhalla, New York 10595, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: McClung
authors.forename: R N
authors.initials: RN
authors.lastname: Belkin
authors.forename: S S
authors.initials: SS
authors.lastname: Chaudhry
mesh_terms: D001783:Blood Flow Velocity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal; D005260:Female; D005402:Fistula / Q000150:complications / Q000503:physiopathology*; D006325:Heart Atria; D006331:Heart Diseases / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications / Q000503:physiopathology*