Presence and characteristics of coronary artery fistulas among patients undergoing coronary angiography

Background: Coronary artery fistula is defined as a connection between one or more coronary artery and a heart chamber. Aims: The aim of the study was to determine the overall incidence of coronary artery fistulas in Polish patients undergoing diagnostic coronary artery angiography as well as the frequency of particular origin and draining sites. Methods: The data were obtained from the Polish National Registry of Invasive Cardiology Procedures among patients hospitalized between January 1, 2014 and December 31, 2016 in invasive cardiology departments in Poland. Results: The study included 298 558 patients. A coronary artery fistula was present in 261 patients (0.087%). There were 131 women (50.19%) and 130 men (49.81%). The most frequent origin of a coronary artery fistula was the left anterior descending artery (167 cases, 59.22%). The pulmonary artery was the most frequent drainage site for fistulas originating from the left anterior descending artery and the right coronary artery (84 cases, 50.30% and 25 cases, 31.65%, respectively). Fistulas originating from the circumflex artery most frequently drained into another artery (10 cases, 27.78%). Conclusions: The left anterior descending coronary artery was the origin site for more than half of all detected coronary artery fistulas. The pulmonary artery was the most frequent origin and drainage site for coronary artery fistulas