DOI: 10.12890/2025_005536

Conus branch fistula to main pulmonary artery: a rare coronary anomaly that may cause chest pain in a pediatric patient

Authors

  • Leila Bigdelu Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Ossama Maadarani Critical Care Unit, Internal Medical Department, Ahmadi Hospital, Kuwait Oil Company (KOC), Al Ahmadi, Kuwait
  • Ali Azari Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  • Ali Heidari-Bakavoli Department of Imaging, Razavi Hospital, Mashhad, Iran
  • Zouheir Bitar Critical Care Unit, Internal Medical Department, Ahmadi Hospital, Kuwait Oil Company (KOC), Al Ahmadi, Kuwait

omaadarani@kockw.com

Keywords

Echocardiography, cardiac computed tomography, conus branch, fistula

Abstract

Coronary artery fistulas (CAFs) are rare congenital coronary anomalies where abnormal communication develops between coronary arteries and cardiac chambers or a thoracic great vessel. CAF is usually diagnosed incidentally with cardiac imaging. Although the majority of fistulas are congenital, iatrogenic CAFs are increasingly observed due to multiple cardiac interventions or direct chest trauma. CAFs in children may result in hemodynamically significant problems due to vascular shunting. We report an 11-year-old boy who presented with atypical chest pain and was found to have a rare variant of CAF; fortunately, he had no significant hemodynamic complications.

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References

  1. Lim JJ, Jung JI, Lee BY, Lee HG. Prevalence and types of coronary artery fistulas detected with coronary CT angiography. AJR Am J Roentgenol 2014;203:W237-W243. doi:10.2214/AJR.13.11613
  2. Gillebert C, Van Hoof R, Van de Werf F, Piessens J, De Geest H. “Coronary artery fistulas in an adult population”. Eur Heart J 1986;7:437-443. doi: 10.1093/oxfordjournals.eurheartj.a062086
  3. Padfield GJ. A case of coronary cameral fistula. Eur J Echocardiogr 2009;10:718–720. doi: 10.1093/ejechocard/jep049
  4. Zenooz NA, Habibi R, Mammen L, Finn JP, Gilkeson RC. Coronary artery fistulas: CT findings. RadioGraphics 2009;29:781–789. doi: 10.1148/rg.293085120
  5. Christmann M, Hoop R, Dave H, Quandt D, Knirsch W, Kretschmar O.Closure of coronary artery fistula in childhood: treatment techniques and long-term follow-up. Clin Res Cardiol 2017;106:211–8. doi: 10.1007/s00392-016-1041-6
  6. Sunder K.R., Balakrishnan K.G., Tharakan J.A., et al. “Coronary artery fistula in children and adults: a review of 25 cases with long-term observations”. Int J Cardiol 1997;58:47-53. doi: 10.1016/s0167-5273(96)02792-1
  7. Özen MB, Durmaz T, Ayhan H, Erdogan M. Multiple fistulae of all three coronary arteries draining into the pulmonary artery and concomitant coronary anomaly. Rev Port Cardiol 2017;36:149-50. doi: https://doi.org/10.1016/j.repc.2016.03.011
  8. Kamal MM, Sundardas R, Sohail AA, Usman M, Iqbal S, Tipu FA, Fatimi SH. Coronary artery to pulmonary artery fistula: Catheter or scalpel? A case report. Int J Surg Case Rep 2022;97:107416. doi: 10.1016/j.ijscr.2022.107416

Published

2025-06-05

Issue

Vol. 12 No. 7 (2025)

Categories

How to Cite

1.
Bigdelu L, Maadarani O, Azari A, Heidari-Bakavoli A, Bitar Z. Conus branch fistula to main pulmonary artery: a rare coronary anomaly that may cause chest pain in a pediatric patient. EJCRIM [Internet]. 2025 Jun. 5 [cited 2026 Nov. 4];12(7). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5536

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