# Detection of Coronary Artery Fistula between the LAD and the Great Cardiac Vein on Coronary CT Angiography

## TL;DR

This paper presents a case where coronary CT angiography was used to detect an abnormal connection between a coronary artery and a cardiac vein in a 77-year-old woman.

## Contribution

The study highlights the use of non-invasive coronary CT angiography for diagnosing a rare type of coronary artery fistula.

## Key findings

- Coronary CT angiography successfully identified a fistula between the left anterior descending artery and the great cardiac vein.
- The case demonstrates the diagnostic capability of CT angiography in visualizing complex coronary anatomy.
- The method avoids the need for invasive procedures in diagnosing coronary artery fistulas.

## Abstract

Coronary artery fistulas (CAFs) are abnormal communications of coronary arteries whereby venous circuits bypass the normal capillaries within the myocardium. Coronary artery-to-cardiac vein fistula is the third most common type of CAF, accounting for 7% of cases. Electrocardiographic-gated cardiac computed tomographic (CT) angiography has emerged as a noninvasive alternative method of choice for diagnosis due to its high spatial and temporal resolution and short acquisition time. Herein, we aimed to present a left anterior descending coronary artery opened into the greater cardiac vein at the distal level, consistent with a coronary artery-to-cardiac vein fistula in a 77-year-old woman.

Teaching point: Coronary artery CT angiography provides a detailed evaluation of the complex anatomy of coronary artery fistula without the need for invasive methods.