Diagnosis of a left coronary artery to right ventricular fistula with progression to spontaneous closure

Coronary artery fistulas in structurally normal hearts are rare. The natura l history of these lesions depends on their size and can cause congestive h eart failure, infective endocarditis, ischemia, or accelerated atherosclero sis. These fistulas are usually closed either in the catheterization labora tory or surgically. This case demonstrates the prenatal diagnosis of a left coronary to right ventricular fistula and documents its natural history to spontaneous closure by 1 year of age. This may help confirm the rationale of observation rather than closure of small fistulas in selected cases of p atients without symptoms.