Coronary artery to left ventricle fistula.
BACKGROUND
Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle.


METHODS
We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow.


CONCLUSIONS
The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.
López-Candales
Angel
A
Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. lopezcandalesa@upmc.edu
Kumar
Vivek
V
D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging* / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*