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  • Title: Congenital high flow coronary cameral fistula in an 81-year-old woman: management problems.
    Author: Millaire A, Goullard L, De Groote P, Ducloux G.
    Journal: Can J Cardiol; 1992 Nov; 8(9):917-20. PubMed ID: 1486542.
    Abstract:
    An 81-year-old woman presenting with severe congestive heart failure was found to have a congenital right coronary fistula draining into the superior vena cava. The diagnosis was suspected on transthoracic two-dimensional echo-Doppler study and confirmed with coronary angiography. Transesophageal echocardiography and magnetic resonance imaging were nondiagnostic. An attempt to close the fistula with transcatheter embolization using a detachable latex balloon was unsuccessful because of the very large size of the fistula. Follow-up showed a favorable outcome with medical therapy. Despite the advent of more recent diagnostic and therapeutic techniques, management of such large fistulae remains unresolved.
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