Korean J Med.  2016 Jun;90(6):518-523. 10.3904/kjm.2016.90.6.518.

Right Coronary Artery to Left Ventricular Fistula with Giant Right Coronary Artery Aneurysm

• Kim EY
• Park JS
• Jeon DS
• Jeong SS
• Park KJ
• Woo JS
• Kang EJ

• KMID: 2218774
• DOI: http://doi.org/10.3904/kjm.2016.90.6.518

Abstract

A 35-year-old male with exertional dyspnea was transferred to our hospital for evaluation of a diastolic murmur and cardiomegaly discovered by chest X-ray. Two-dimensional and Doppler echocardiographic studies revealed an aneurysmal dilation of the right coronary artery (RCA) and diastolic inflow from the RCA to the left ventricle (LV) through a myocardial defect 11 mm in diameter in the basal inferior LV wall. Coronary computed tomography angiography (CCTA) confirmed the presence of a giant RCA to LV fistula. Due to the risks for developing overt left heart failure and spontaneous rupture of the giant RCA, the RCA was obliterated surgically. Coronary-cameral fistulas are a rare congenital coronary artery anomaly. A fistula between the coronary artery and LV, especially when combined with coronary artery aneurysm, is a rare occurrence in the literature. Here, we report a case of a giant RCA to LV fistula detected by echocardiography and CCTA.

Keyword

Coronary vessels; Coronary vessel anomalies; Fistula; Aneurysm

MeSH Terms

Adult
Aneurysm*
Angiography
Cardiomegaly
Coronary Vessel Anomalies
Coronary Vessels*
Dyspnea
Echocardiography
Fistula*
Heart Failure
Heart Murmurs
Heart Ventricles
Humans
Male
Rupture, Spontaneous
Thorax