Prominent systolic coronary flow in a coronary artery fistula with a giantaneurysma

A 68-year-old Japanese woman was admitted to hospital because Of Chest oppr ession during exertion, Coronary angiography showed a coronary artery fistu la with a giant aneurysm. which originated from both the left anterior desc ending (LAD) and right coronary arteries, We investigated coronary blood fl ow, velocity Using the Doppler guide ire technique. The coronary flow patte rn showed a very prominent systolic component. whereas the diastolic flow c omponents were nearly normal before the operation at the LAD site proximal to the coronary artery fistula. This pattern returned to normal after the o peration, This report describes the relationship between the coronary steal phenomenon and coronary flow, dynamics investigated directly using the Dop pler guidewire technique.