DIAGNOSIS AND CLINICAL COURSE OF CORONARY -RIGHT VENTRICULAR FISTULA BASED ON 2 CLINICAL CASES

The authors report two cases of coronary-right ventricular fistulas di agnosed in a 7-month-old infant and a 9-year-old girl. The discovery o f the heart disease was incidental in both cases, following detection of a low continuous murmur. Doppler ultrasonography established the di agnosis, which was confirmed by haemodynamic studies and coronary angi ography. The left anterior descending artery was involved in both case s and the recipient cavity was the right ventricle. The first patient was cured by early operation with distal ligation of the artery. In th e second patient, the natural course was complicated by aneurysmal dil atation of the. coronary artery. The authors recall the value of colou r Doppler ultrasound in the noninvasive diagnosis, especially of the r ecipient cavity by colour Doppler and the need to rapidly treat corona ry fistulas to prevent the development of complications reported after an average age of 20 years.