Coronary artery fistulas are rare defects in the coronary circulation system. They are congenital or acquired malformations in the assembly and circuitry of coronary arteries. Coronary artery fistulas can be grouped into two broad categories. Coronary-cameral fistulas are abnormal connections between coronary arteries and any of the heart chambers. Coronary arteriovenous malformations are abnormal connections that occur between coronary arteries and parts of the systemic/pulmonary circulatory vessels. Although the majority of coronary artery fistulas are diagnosed incidentally on coronary catheterization, there is a portion of patients with this disease who can present with signs and symptoms of congestive heart failure, myocardial infarction, pulmonary hypertension, and other cardiopulmonary functional abnormalities. With regards to diagnosis, coronary angiography, and coronary computerized tomography angiography (CTA) are considered highly reliable in diagnosing coronary artery fistulas. Catheterized closure is generally indicated as the main modality of treatment.
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