DOPPLER-ECHOCARDIOGRAPHY DIAGNOSIS OF A F ISTULA BETWEEN THE CIRCUMFLEX ARTERY AND CORONARY SINUS IN A TODDLER

In a two-year-old with a continuous murmur and clinical evidence of a left-to-right shunt, Doppler echocardiography showed a fistula between the circumflex artery and the coronary sinus. The circumflex artery, which was visualized along its full length, was dilated, and emptied i nto the coronary sinus. An abnormal systolodiastolic flow was recorded in the right atrium, near the coronary sinus ostium. The fistula was closed surgically after confirmation of the diagnosis by selective art eriography. The outcome was favorable. Fistulas between a coronary art ery and the coronary sinus are rare and the number of reports of Doppl er echocardiography diagnosis of coronary artery-cardiac chamber fistu las is still small.