Transcatheter Coil Embolization for Coronary Artery Fistula with Giant Aneurysm Originating from Left Circumflex Artery and Drainage to Right Ventricle

Coronary artery fistulae (CAF) represent the most frequent congenital anomalies influencing hemodynamic parameters of coronary arteries. However, CAF complicated with a huge aneurysm does not frequently occur. Determining the optimal management of symptomatic patients with CAF and aneurysm still remains a challenging problem, and has been traditionally considered as an indication for cardiac surgery. The use of transcatheter coil embolization for CAF has emerged as a less invasive strategy, and has recently been considered as an alternative to surgical correction. We reported a 71-year-old male patient with a congenital CAF, originating from the left circumflex artery and draining into the right ventricle, complicated with a giant aneurysm presenting with typical angina pectoris and exertional dyspnea. This patient underwent successful transcatheter closure of both the fistula and aneurysm using a coil embolization technique, and had an uneventful recovery after treatment.