An extremely rare coronary artery fistula extending from the sinoatrial nodal artery to the right atrium

OpenAlex İngilizce

A 28-year-old female was admitted to our hospital with complaints of palpitations and fatigue.The patient's medical history was unremarkable.The physical examination revealed a hyperkinetic precordium (heart rate 108/min) and a continuous murmur (systolodiastolic) on the right side of the sternum.The patient's blood pressure was 120/70 mmHg.Electrocardiogram revealed atrial fibrillation with a high ventricular rate.Two-dimensional transthoracic echocardiography (TTE) detected a markedly enlarged right atrium and aneurysmatic right coronary ostium with no abnormalities of other cardiac structures (Figure 1a).The left ventricular ejection fraction was 60%.Selective coronary angiography revealed a tunnel-like connection that seemed like a fistula extending from the right coronary sinus of Valsalva to the right atrium (Figure 1b).The pulmonary-to-systemic blood flow ratio (Qp/Qs) was assessed as 1.18 during right cardiac catheterization.The pulmonary artery pressure was 32 mmHg.The images obtained with cardiac multidetector computed tomography (MDCT) revealed a dilated tunnel coursed from the right coronary sinus to the An extremely rare coronary artery fistula extending from the sinoatrial