Transcatheter closure of coronary-to-pulmonary fistula by nonconventional coils in a patient with tetralogy of Fallot

Right Coronary Artery to Pulmonary Arterial Fistula Associated With Tetralogy of Fallot

A 16-year-old boy with tetralogy of Fallot (TOF), pulmonary stenosis, and coronary artery to pulmonary arterial fistulous communication arising from the proximal right coronary artery is reported for its rarity. The surgical importance of this anomaly is highlighted. The diagnosis should be borne in cases of TOF, with echocardiographic demonstration of severe right ventricular outflow tract obstruction without a corresponding degree of systemic arterial desaturation.

Multiple coronary to pulmonary artery fistulas: a case report and review of the literature

Coronary to pulmonary artery fistulae (CAF) are rare cardiac anomalies. The majority arise from the right coronary artery, with fistulae originating from the left anterior descending artery or from multiple arteries being less common. CAF are frequently asymptomatic and found incidentally on routine cardiac imaging. We present the case of a 61-year-old woman with multiple CAF who presented with progressive shortness of breath and chest pain and was ultimately treated successfully with trans-catheter coiling with marked improvement in symptoms. We also review the currently available literature regarding advances in diagnosis and treatment of CAF.