# Percutaneous Closure of a Diagonal Artery to Pulmonary Artery Fistula

## TL;DR

A patient with a rare heart artery abnormality causing chest pain was successfully treated with a minimally invasive procedure.

## Contribution

This case highlights successful coil embolization for a symptomatic diagonal artery to pulmonary artery fistula.

## Key findings

- Coronary angiography identified a fistula between the diagonal artery and pulmonary artery.
- Coil embolization resolved the patient's angina symptoms effectively.
- CT angiography provided detailed anatomy for procedural planning.

## Abstract

Coronary artery fistulas are uncommon anomalies that are typically asymptomatic and incidentally identified through coronary angiography or computed tomographic angiography. In this clinical vignette, we report a symptomatic patient with exertional angina and anterior ischemia on exercise stress testing. Coronary angiography revealed a fistula between the proximal diagonal artery and the main pulmonary artery. Coronary computed tomographic angiography provided precise anatomical detail, facilitating procedural planning. The patient underwent successful coil embolization of the fistula, resulting in complete resolution of angina.