Congenital coronary-cameral fistulas; multiple micro-fistulas versus large solitary macro cameral fistula, case reports and the occlusion technique with Occlutech Duct Occluder

A congenital coronary arteriovenous fistula is a communication between a coronary artery branch and any of the four cardiac chambers or even coronary sinus, superior vena cava, pulmonary artery, or pulmonary veins as well. This anomaly can be divided into two main categories: coronary artery-ventricular multiple micro-fistulas (MMFs) and solitary small or large macro fistula. Herein, we present a case of ventricular MMFs associated with apical hypertrophic cardiomyopathy and a case of solitary macro-fistulas originated from left circumflex coronary artery to the coronary sinus.

Coronary cameral fistulas (CCFs) should be considered as a differential diagnosis in apical HCM cases presenting with chest pain and echocardiography could have a promising role in this context. Meanwhile a large solitary coronary cameral fistula can present as continuous murmur in asymptomatic adults or even babies as well.