A Rare Case of a Giant Coronary Sinus with Focal Aneurysm Secondary to Multiple Fistulous Connections Arising from a Dilated Tortuous Left Circumflex Coronary Artery

摘要

class="kwd-title">Keywords: Coronary artery fistula, Dilated coronary sinus, Three-dimensional echocardiography, TTE class="head no_bottom_margin" id="sec1title">IntroductionCoronary arteriovenous fistula (CAF) is an abnormal connection directly linking one or more coronary arteries to either a cardiac chamber or major vessel without an interposed capillary bed. CAFs are uncommon and are usually an incidental finding, with drainage into the coronary sinus being one of the least prevalent forms. Two-dimensional and three-dimensional transthoracic echocardiography (TTE) often provides the initial diagnosis, along with identifying associated defects and hemodynamic changes, with additional multimodality imaging used to delineate the origin and termination of CAF. We describe a rare and incidental case of two fistulous connections between the distal left circumflex coronary artery (LCx) and a grossly dilated coronary sinus.