Multimodality Imaging of Giant Coronary Aneurysm and Spontaneous Thrombosis With Left Coronary Artery‐Right Atrium Fistula

Coronary artery fistulas (CAF) are rare and can be subdivided into coronary-cameral fistulas and coronary arteriovenous fistulas. The majority of these fistulae drain into the right atrium or the pulmonary artery. The right coronary artery (RCA) is the most common site for CAF, accounting for approximately 55% of cases, followed by the left coronary artery（LCA ） (35%). Usually, CAF are discovered accidentally for no unique features and symptoms. However, symptoms such as myocardial ischemia, heart failure, and arrhythmias may appear when the patient has a large shunt volume. Given the presence of high-risk factors such as aneurysm rupture, thrombosis, and atrial fibrillation (AF), surgical intervention was performed on this patient.