RIGHT CORONARY-ARTERY CIRSOID WITH FISTULOUS CONNECTION TO THE CORONARY SINUS

A 61-yr-old woman was referred to our hospital for evaluation of a sus pected right atrial myxoma. The transesophageal echocardiogram suggest ed the presence of an anomalous right coronary artery with fistulous c onnection to the coronary sinus. At cardiac catheterization, an oxygen stepup in the right atrium indicated a 1.3:1.0 left-to-right shunt. A ortic root angiography showed a large and calcified right coronary art ery cirsoid draining to the coronary sinus, which appeared remarkably dilated. In this rare anomaly, cardiac catheterization is necessary, n ot only to quantify the magnitude of the left-to-right shunt, which is an important requirement for the indication to surgical treatment, bu t also to confirm the echocardiographic diagnosis. (c) 1993 Wiley-Liss , Inc.