Percutaneous Coil Closure of a Large Left Coronary Artery Fistula in an Asymptomatic Child

TL;DR

A large left coronary artery fistula in an asymptomatic child was successfully closed using a minimally invasive coil procedure.

Contribution

The paper presents a successful case of percutaneous coil closure for a large coronary artery fistula in an asymptomatic pediatric patient.

Findings

Echocardiography identified a hemodynamically significant left coronary artery fistula draining into the right ventricle.

Percutaneous closure using two coils was performed successfully without complications.

Aneurysmal dilation at the fistula's end was confirmed during diagnostic catheterization.

Abstract

Coronary artery fistulas (CAFs) are rare cardiac anomalies characterized by an abnormal connection between the coronary arteries and either a cardiac chamber or a large thoracic vessel. While the majority of CAF cases are asymptomatic, serious cardiac complications can occur, especially with moderate to large fistulas. We describe a case of a large-sized left coronary artery (LCA) fistula in an asymptomatic 11-year-old who was referred for cardiac evaluation due to a systolic murmur. An echocardiogram revealed a hemodynamically significant fistula arising from the LCA draining into the right ventricle. Diagnostic catheterization confirmed the origin and draining site of the fistula, along with aneurysmal dilation at the end of the fistula. The fistula was successfully closed percutaneously using a two-coil occlusive device, with no complication observed.

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