This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by NEUFELD, H. N. Articles by EDWARDS, J. E. Search for Related Content PubMed Articles by NEUFELD, H. N. Articles by EDWARDS, J. E.

(Circulation. 1961;24:171.)
© 1961 American Heart Association, Inc.

---

Congenital Communication of a Coronary Artery with a Cardiac Chamber or the Pulmonary Trunk ("Coronary Artery Fistula")

HENRY N. NEUFELD M.D.¹; RICHARD G. LESTER M.D.¹; PAUL ADAMS JR. M.D.¹; RAY C. ANDERSON M.D.¹; C. WALTON LILLEHEI M.D.¹; JESSE E. EDWARDS M.D.¹

¹ From the Departments of Radiology, Pediatrics, Surgery, and Pathology, University of Minnesota, Minneapolis, Minnesota, and the Department of Pathology, Charles T. Miller Hospital, St. Paul, Minnesota.

Anatomic, clinical, hemodynamic, and roentgenographic findings in six patients with congenital communication of a coronary artery with a cardiac chamber or the pulmonary trunk are presented. The literature is reviewed.

A coronary artery may communicate anomalously, with any of the cardiac chambers, more commonly with those on the right side. In the six cases presented, the right coronary artery communicated with the right atrium in one case and with the right ventricle in another. The left coronary artery communicated with the right atrium and right ventricle in one case each, and with the pulmonary trunk in two cases.

The most striking feature observed clinically was a continuous murmur. If a continous murmur is localized in an area atypical for patent ductus arteriosus, the diagnosis should be suspected. Conventional roentgenographic and electrocardiographic studies yielded no specific diagnostic features. The results of cardiac catheterization may reveal a left-to-right shunt, but they are diagnostically useful only when correlated with clinical findings.

The only precise method of demonstrating the abnormality is by means of selective aortography performed by injecting medium into the very origin of the aorta.

Cure is possible by surgical interruption of the fistulous tract.

This article has been cited by other articles:

				M. T. T. Takaki, T. J. Dubinsky, B. H. Warren, L. Mitsumori, and W. P. Shuman Nonatherosclerotic Cardiovascular Findings on MDCT Coronary Angiography: A Selection of Abnormalities Am. J. Roentgenol., April 1, 2008; 190(4): 934 - 946. [Abstract] [Full Text] [PDF]

				S. Y. Kim, J. B. Seo, K.-H. Do, J.-N. Heo, J. S. Lee, J.-W. Song, Y. H. Choe, T. H. Kim, H. S. Yong, S. I. Choi, et al. Coronary Artery Anomalies: Classification and ECG-gated Multi-Detector Row CT Findings with Angiographic Correlation. RadioGraphics, March 1, 2006; 26(2): 317 - 333. [Abstract] [Full Text] [PDF]

				A. C. Burns, S. Osula, A. Harley, and A. Rashid Left circumflex coronary artery to left atrial fistula in a patient with mitral regurgitation after excision of a left atrial myxoma Ann. Thorac. Surg., November 1, 2001; 72(5): 1732 - 1733. [Abstract] [Full Text] [PDF]

				T. Kwan and A. Feit Late Neovascularization of Longstanding Left Ventricular Mural Thrombus--A Case Report Angiology, August 1, 1993; 44(8): 647 - 650. [Abstract] [PDF]