Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature.
BACKGROUND
Coronary bronchial artery fistulas (CBFs) are rare anomalies, which may be isolated or associated with other disorders.


METHODS
Two adult patients with CBFs are described and a PubMed search was performed using the keywords "coronary bronchial artery fistulas" in the period from 2008 to 2013.


RESULTS
Twenty-seven reviewed subjects resulting in a total of 31 fistulas were collected. Asymptomatic presentation was reported in 5 subjects (19 %), chest pain (n = 17) was frequently present followed by haemoptysis (n = 7) and dyspnoea (n = 5). Concomitant disorders were bronchiectasis (44 %), diabetes (33 %) and hypertension (28 %). Multimodality and single-modality diagnostic strategies were applied in 56 % and 44 %, respectively. The origin of the CBFs was the left circumflex artery in 61 %, the right coronary artery in 36 % and the left anterior descending artery in 3 %. Management was conservative (22 %), surgical ligation (11 %), percutaneous transcatheter embolisation (30 %), awaiting lung transplantation (7 %) or not reported (30 %).


CONCLUSIONS
CBFs may remain clinically silent, or present with chest pain or haemoptysis. CBFs are commonly associated with bronchiectasis and usually require a multimodality approach to be diagnosed. Several treatment strategies are available. This report presents two adult cases with CBFs and a review of the literature.
Department of Cardiology, Hospital Group Twente, Geerdinksweg 141, 7555 DL, Hengelo, the Netherlands, s.said@zgt.nl.
S A M
SA
Said
R M
RM
Oortman
J-H
JH
Hofstra
P M J
PM
Verhorst
R H J A
RH
Slart
M W
MW
de Haan
F
F
Eerens
H J G M
HJ
Crijns