Definition

Coronary artery fistula is an abnormal connection between the coronary artery and the heart or other blood vessels. Coronary arteries carry oxygen-rich blood to the heart tissue. A small fistula will not affect this blood flow, but larger ones may cause problems.

The Coronary Arteries

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Causes

This is often caused by a congenital defect. This means that a baby is born with it. It is not known exactly why this happens.

Some fistulas can also happen after birth due to infection, injury, or heart surgery.

Risk Factors

Risk factors for this problem are not known.

Symptoms

Most children with mild fistulas do not have symptoms. Rarely, those who do have symptoms may have:

• Chest pain
• Fast heartbeat

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the heart. This problem may be suspected if the doctor hears a heart murmur.

Images may be taken of your child's body. This can be done with:

• Echocardiogram
• Chest x-ray

Your child's heart function may be tested. This can be done with:

• Electrocardiogram
• Cardiac catheterization

Treatment

Surgery will be done to correct the defect. Choices are:

• Coil embolization to close off the abnormal vessel by placing a coil through blood vessels in the arms or legs and passing it to the heart
• Open heart surgery to close the defect with stitches

Lifelong heart monitoring will be needed after treatment.

Prevention

There are no known guidelines to prevent this heart problem.