Bilateral Congenital Coronary Artery-Pulmonary Artery Fistulae

Gupte, Subodh S.; Ryan, Gerald F.; Easley Jr., Robert M.
April 1979
Angiology;Apr1979, Vol. 30 Issue 4, p276
Academic Journal
Congenital coronary arteriovenous fistulae involving both coronary arteries are rare. Those terminating in a right heart chamber or the pulmonary artery usually mimic a patent ductus arteriosus because of the presence of a continuous murmur.3,20 Since the vascular resistance is much lower in the pulmonary circuit than in myocardial capillaries, a large percentage of coronary blood flow may be directed through the fistula. 14,15 Such a "steal" can cause myocardial ischemia distal to the origin of the fistula. 21 Angina has been reported to occur. 2,4,6,15 About 20% of coronary A-V fistulae are associated with other congenital cardiac anomalies. 15


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