Spontaneous Complete Closure of a Congenital Coronary Artery Fistula

Case Details

Personal Characteristics

14-month-old boy, asymptomatic, normal growth and development

Clinical Characteristics

Heart murmur noted at 2 months of age, small left to right shunt detected at 14 months, murmur present at 2 and 3 years, murmur disappeared over 4 year period, normal coronary vessels and circulation at 5 1/2 years

Remission Characteristics

Spontaneous closure of the fistula, disappearance of the murmur

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Elective cardiac catheterization and angiography at 14 months, selective coronary arteriography at 5 1/2 years

Additional Notes

Six other cases of coronary fistula observed during the past 10 years are also reviewed. This study supports the rationale for clinical follow-up rather than obligatory surgical intervention in asymptomatic patients with a small shunt who have no evidence of myocardial dysfunction. (Permission to reproduce case report denied by author.)