Prenatal Diagnosis of Coronary Artery Fistula: A Case Report and Review of Literature

Coronary artery fistula (CAF) is a connection between a coronary artery on one side and a cardiac chamber or great vessel on the other side that bypasses themyocardial capillary bed. CAF was first described by Krause1 in 1865 and accounts for 0.2 to 0.4 % of all congenital heart disease and 14 % of congenital anomalies of the coronary arteries. It can occur in isolation or in association with other congenital heart dis-ease.2 CAF arises from the right coronary artery (RCA), left anterior descending coronary artery, and the circumflex coronary artery in 52, 30, and 18 % of cases, respectively. Over 90 % of CAF drain to the right side of the heart, most commonly to the right ventricle (RV) in approximately 40 % of the cases, followed by the right atrium, coronary sinus, and pulmonary trunk. Multiple CAF to the left ventricle have also been reported