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Large common left and right coronary artery to coronary sinus fistula

^a Department of Cardiology, Thoraxcenter, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, The Netherlands
^b Department of Thoracic Surgery, University Medical Center Groningen, The Netherlands
^c Department of Radiology, University Medical Center Groningen, The Netherlands

*Corresponding author. Fax: +31 50 3614884.

E-mail address: e.s.hoendermis{at}thorax.umcg.nl (E.S. Hoendermis).

Coronary fistulas are vascular anomalies which in rare cases can cause hemodynamic problems with indication for intervention. We report about a 47-year-old man with a large coronary fistula arising from both, the left and right coronary artery. To our knowledge this is the first case described with this anatomy. The main coronary arteries were united at the crux cordis and drained through the coronary sinus into the right atrium. As a consequence of the longstanding volume overload the coronary arteries were extremely dilated. Also, both ventricles were dilated. Therefore, although the patient was asymptomatic, the obvious compromise of the ventricles due to volume overload was regarded as an indication for surgical intervention.

Key Words: Congenital; Congestive heart failure; Coronary fistula