Four-dimensional flow cardiac magnetic resonance visualization and quantification of a large coronary fistula

A 71-year-old man with an unremarkable medical history was referred to our centre for right heart failure with atrial fibrillation. Transthoracic echocardiography showed dilation of both atria (left 44.8 cm2 and right 49.6 cm2) and ventricles (end diastole: right 48  mm and left 69 mm) with tricuspid and mitral regurgitation (Supplementary material onlineSupplementary material online,Video SA). Systolic function was moderately impaired (left ejection fraction 40%). The left coronary artery was dilated (15  mm) with continuous flow in a markedly dilated coronary sinus (CS) (Supplementary material onlineSupplementary material online,Videos SB andSC). There was no left superior vena cava. A large coronary fistula between the circumflex artery and CS was diagnosed.
Source: European Heart Journal - Category: Cardiology Source Type: research