Diagnosis, Management, and Treatment of Coronary Artery Fistulas: Three Case Reports and Literature Review

Coronary artery fistulas represent a form of congenital coronary arteriovenous malformation.They originate from coronary arteries and most commonly drain into the right atrium and right ventricle, with less frequent drainage into the coronary sinus or pulmonary trunk.Clinical manifestations are influenced by the extent of the left-to-right shunt, which can result in ischemia due to diversion of blood from the nearby myocardium, despite the absence of atherosclerotic coronary artery disease.Coronary angiography continues to be the primary method for diagnosis and enables the interventional closure of these fistulas.Current congenital heart disease guidelines recommend considering both symptoms and fistula size when determining the need for closure.This report represents three patients evaluated in our outpatient clinic who underwent successful treatment with percutaneous coil embolization.