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MRI evaluation of congenital coronary artery fistulae

¹ Magnetic Resonance Section, ² Congenital Cardiology Department and ³ Surgery Division, Heart Institute (InCor), University of Sao Paulo Medical School, Brazil. Av. Dr. Eneas de Carvalho Aguiar, 44, Sao Paulo, SP, Brazil, 05403-000

Congenital coronary artery fistula is a rare disease and MRI is a promising technique that may be useful to demonstrate the coronary artery tree. We report three patients who underwent cardiac MRI to investigate right coronary artery fistulae. On clinical examination, a continuous murmur was heard along the left sternal border, and chest X-ray showed moderate cardiomegaly with enlargement of right chambers in all patients. Transthoracic Doppler echocardiography showed fistulae in two cases; the third case was not demonstrated by transthoracic or transoesophageal echocardiography. MRI demonstrated the course of the fistulous vessels in all patients. All patients underwent surgical closure of their coronary artery fistulae. MRI may show detailed anatomy of congenital coronary artery fistulae and may be useful as an additional non-invasive method in their investigation.

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