Left to right shunt for congenital coronary arterio-venous fistulas

Congenital coronary artery fistulas are rare malformations that may evolve to pulmonary hypertension, heart failure and myocardial ischemia, although some may close spontaneously. Complications such as endocarditis, rupture, aneurysm or thrombosis may also be observed. Most patients are asymptomatic and the fistulas are usually detected by doppler echocardiography and angi ography. We report the case of an asymptomatic 10-year-old male who was sub mitted because he of a heart murmur, and three coronary fistulas were diagn osed. Two originated in the left coronary artery draining into the right ve ntricle and the other origin was in the right coronary artery draining into the pulmonary artery trunk.