Percutaneous Closure of Fistulous Tract from Right Coronary Artery to Right Atrium: A Case Report

The coronary artery fistula is a rare form of left to right shunt that can lead to significant hemodynamic consequences if left untreated. The patient, a 10-year-old female, presented with symptoms of increasing dyspnea and palpitations over the past year. Diagnostic imaging, including transthoracic echocardiography and cardiac computed axial tomography, confirmed the presence of a fistulous connection between the right coronary artery and the right atrium. Given the patient’s symptomatic presentation and the risk of complications, a decision was made to proceed with percutaneous closure. Using a catheter-based approach, the fistula was successfully occluded with a Amplatzer Vascular Plug II (AVP II), resulting in the resolution of symptoms and normalization of hemodynamic parameters. This case highlights the efficacy and safety of percutaneous intervention in managing coronary artery fistulas, particularly in pediatric patients, and underscores the importance of early diagnosis and treatment to prevent long-term sequelae.