Massively Enlarged Right Coronary Artery With Fistula to the Coronary Sinus: To Close or Not to Close?

Images of the month 1: An unusual case of breathlessness – coronary artery fistula draining into the left ventricle

“…Repair is indicated where there is demonstrable ischemia or shunt-related symptoms eg breathlessness. 1 It is important to monitor closely in those not undergoing intervention; demonstrated in one case where the patient was lost to followup and subsequently demonstrated a tripling in the size of the coronary artery in the 30 years after the identification of the lesion. 2 ■…”