COMPLETE VISUALIZATION OF A CORONARY-ARTERY FISTULA WITH DRAINAGE IN THE VENA-CAVA-SUPERIOR - DIAGNOSTIC BENEFIT OF BIPLANE TRANSESOPHAGEALECHOCARDIOGRAPHY

A 36-year-old woman was referred because of a continuous cardiac murmu r. Standard transthoracic two-dimensional echocardiography was normal. Using the transverse plane of biplane transesophageal echocardiograph y (TEE) a distinct dilatation of the proximal portion of the right cor onary artery could be visualized. Morphology and the information from color-coded Doppler echocardiography were consistent with a coronary a rtery fistula. However, the exact course of the fistula and its draina ge could not be seen. Only by using the longitudinal plane of biplane TEE its site of drainage into the vena cava superior could be demonstr ated morphologically, as well as by color-coded Doppler imaging.