Coronary Artery Fistulae In Jeddah

Abstract

INTRODUCTION:
Congenital coronary arteriovenous fistula is not common (1), since Krause first described coronary arteriovenous flstula in 1865 (2), and Bjork first reported on its surgical treatment in 1947 (3), 300 cases have been reported. Surgical corrections have been documented for fistulous connections between the coronary arteries and the cardiac chambers (1). The majority of the fistulae originate in the coronary artery and terminate on the right side of the heart (right ventricle, right atrium, pulmonary artery, in that order of frequency), and rarely into the left atrium (1). Cases of rarer sites of communication such as peripheral pulmonary arteries have been reported (4), and this occurred with left coronary artery.

DISCUSSION:
All the three cases described represent a common from of coronary arteriovenous fistula formation into the right side of the heart (mainly the right atrium). Half of the congenital coronary arte ii ovenou s fi stul ae originate from the right coronary artery and 92% of all coronary fistulae enter the right side of the heart (1,5). Cardiac catheterization, aortography and selective coronary arteriography, if feasible, are essential for proper diagnosis of this anomaly. The lattermethod was applied in our three patients and it worked well.