Work

A Rare Case of Single Coronary Artery With Pulmonary Artery Fistula

Year: 2025

Type: article

Abstract: BACKGROUND: Single coronary artery is a rare congenital anomaly. Its coexistence with coronary artery fistula is exceedingly uncommon. CASE SUMMARY: A 61-year-old woman with no cardiovascular risk factors underwent her first cardiological evaluation after incidental detection of atrial fibrillation. Imaging revealed a markedly dilated single coronary artery originating from the left coronary sinus, with a large fistula to the pulmonary artery trunk. Despite atrial enlargement and moderate mitral and tricuspid regurgitation, the patient was asymptomatic with preserved ventricular function. A conservative management strategy with close follow-up was adopted after multidisciplinary discussion. DISCUSSION: Management of rare coronary anomalies should be individualized. While surgery is recommended in symptomatic patients or those with evidence of ischemia, asymptomatic individuals may be managed conservatively; however, signs of adverse cardiac remodeling should prompt early reconsideration of intervention. TAKE-HOME MESSAGE: Conservative follow-up may be appropriate in asymptomatic patients with complex coronary anomalies, but progressive structural changes warrant timely reassessment of surgical options.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104875

Authors: Giorgia Panichella, Margherita Padeletti, Gaia Spaziani, Iacopo Olivotto, Silvia Favilli

Institutions: University of Florence, Santa Maria Nuova Hospital

Language: English

Topic: Coronary Artery Anomalies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850