TRANSESOPHAGEAL ECHOCARDIOGRAPHIC DIAGNOSIS OF A CONGENITAL CIRCUMFLEX CORONARY-ARTERY TO CORONARY SINUS FISTULA IN AN ADULT

We report a congenital circumflex coronary artery to coronary sinus ar teriovenous fistula diagnosed by transesophageal echocardiography in a 38-year-old asymptomatic male. The coronary arteriovenous fistula was suggested by two-dimensional transthoracic color Doppler. A first non diagnostic angiography was performed, and it was during the second one , that the fistula could finally be visualized after a special dye tec hnique was used. The high fistula flow rate prevented us from seeing i t with regular dye concentration. Transesophageal echocardiography was precise in the anatomical and hemodynamic evaluation and it was essen tial in guiding the angiographic examination and surgical repair.