Juan D. Saavedra-Henao, Departamento de Cirugía Cardiovascular, Clínica Avidanti, Ibagué. Colombia
Alejandro M. Santos-Zabala, Departamento de Hemodinamia, Clínica Avidanti, Ibagué, Colombia
Rafael Figueroa-Casanova, Departamento de Cirugía Cardiovascular, Clínica Avidanti, Ibagué, Colombia
Salma Yasno, Facultad de Medicina, Universidad del Tolima. Ibagué, Colombia
Coronary fistulas are abnormal vascular tracts that connect the coronary arteries to cardiac chambers or vascular structures adjacent to the heart. Fistulas draining into the bronchial arteries are rare. A 54-year-old male patient presented with angina-like chest pain and normal laboratory findings. An outpatient coronary CT angiography showed no evidence of obstruction but revealed a fistula from the circumflex artery to the left bronchial arteries. Coronary arteriography was performed, and the fistula was occluded using coils. The patient was discharged on dual antiplatelet therapy. Coronary-bronchial fistulas are an uncommon finding. Most are asymptomatic, although symptoms may occur due to coronary blood flow being diverted through the fistulous tract. Diagnosis is often incidental, made using non-invasive or invasive imaging techniques. Treatment in symptomatic patients involves closure, while in asymptomatic cases, conservative management may be considered. Fistulas are rare findings but should be evaluated using the available diagnostic imaging modalities. Depending on the symptoms and anatomical characteristics, the appropriate management approach – including closure – should be considered.
Keywords: Fistula. Coronary vessels. Computed tomography angiography. Coronary angiography.
