Conservative Management of a Rare Congenital Left Circumflex Coronary Artery Fistula Draining Into the Coronary Sinus
Year: 2025
Type: article
Study design: Case Report
Abstract: BACKGROUND: Coronary artery fistulas (CAFs) are rare congenital anomalies that may present with symptoms of angina or heart failure due to a coronary steal phenomenon. Diagnosis and treatment are based on symptom severity and anatomical characteristics. CASE SUMMARY: A 68-year-old man presented with chest pain. He had no obstructive coronary disease on coronary computed tomography angiography, but the left circumflex artery was found to be ectatic and draining into the coronary sinus, consistent with a congenital fistula. No evidence of ischemia or shunt was seen on the imaging assessment. The patient was managed conservatively, and he remained asymptomatic during 1 year of follow-up. CONCLUSIONS: Management of CAFs is decided on factors including symptoms and fistula characteristics, leading to a conservative, transcatheter, or surgical approach. TAKE-HOME MESSAGES: Detailed multimodality imaging assessment in CAFs is required. Conservative management is generally recommended in asymptomatic patients.
Source: JACC Case Reports
Authors: Tarek Mahdy, Mohamed Mansour, Edward Hoey, Gurbir Bhatia, George Pulikal
Institution: University Hospitals Birmingham NHS Foundation Trust
Language: English
Topic: Coronary Artery Anomalies
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $850
OpenAlex ID: W4416168983