Comprehensive assessment of left anterior descending coronary artery to pulmonary artery fistula

Alessandro Campari, Silvia Tresoldi, Stefano Lucreziotti, Marco Centola, Gianpaolo Cornalba


A 66-year-old man was hospitalized because of ST elevation myocardial infarction (STEMI). During stent placement in the medium tract of the circumflex artery, conventional coronary angiography (CCA) depicted a fistulous tract between the left anterior descending artery (LAD) and the pulmonary trunk. After exclusion of coronary steal in the LAD territories by means of rest-stress myocardial perfusion scintigraphy (MPS) with Tc-99m, one-year follow up was established. Computed tomography coronary angiography (CTCA) was performed in order to better delineate fistula’s feature and provide a starting point for periodic evaluation. CTCA is less-invasive and more reproducible than conventional coronary angiography (CCA), therefore we suggest it as the modality of choice in the follow-up of coronary artery fistulas in asymptomatic patients.

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International Journal of Diagnostic Imaging

ISSN 2331-5857 (Print)  ISSN 2331-5865 (Online)

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