Transesophageal Coronary Artery
Echocardiographic Assessment of Congenital to Coronary Sinus Fistulas in Adults
Tandaw E. Samdarshi, MD, Edward F. Mahan III, MD, Navin C. Nanda, MD, and Rajat S. Sanyal, MD artery in patient 2. It also correctly delineatedfistulous connection betweenthe left circumflex artery and the coronary sinus near the left atria1 appendage. In contrast, coronary angiography correctly diagnosed theJistulous site only in patient 1. In patient 2, the jistulous site was misdiagnosed as the low posterior right atrium, whereas in patient 3 the precise site of jistula into the coronary sinus could not be identified. Coronary artery fistulas involve the right coronary artery in 50 to 55% of patients, the left coronary artery in 35%, and both coronary arteries in 5%. Low pressure structures are the most common recipient sites and include the right ventricle (40%), right atrium (25%), pulmonary artery ( 15 to 20%), coronary sinus (7%) and the superior vena cava ( 1%).2Coronary artery dilatation is usual and the degreeof dilatation dependson the shunt size. In our patients, the involved coronary arteries were markedly dilated and tortuous in appearance,although the shunts were small. These shunts are usually
Echocardiographic Assessment of Congenital to Coronary Sinus Fistulas in Adults
Tandaw E. Samdarshi, MD, Edward F. Mahan III, MD, Navin C. Nanda, MD, and Rajat S. Sanyal, MD artery in patient 2. It also correctly delineatedfistulous connection betweenthe left circumflex artery and the coronary sinus near the left atria1 appendage. In contrast, coronary angiography correctly diagnosed theJistulous site only in patient 1. In patient 2, the jistulous site was misdiagnosed as the low posterior right atrium, whereas in patient 3 the precise site of jistula into the coronary sinus could not be identified. Coronary artery fistulas involve the right coronary artery in 50 to 55% of patients, the left coronary artery in 35%, and both coronary arteries in 5%. Low pressure structures are the most common recipient sites and include the right ventricle (40%), right atrium (25%), pulmonary artery ( 15 to 20%), coronary sinus (7%) and the superior vena cava ( 1%).2Coronary artery dilatation is usual and the degreeof dilatation dependson the shunt size. In our patients, the involved coronary arteries were markedly dilated and tortuous in appearance,although the shunts were small. These shunts are usually
