Un unusual cause of heart failure. 

Case presentation:

Patient is a 50 y/o male with a past medical history of HTN, ascending aorta repair 1 year ago presenting with heart failure symptoms and was found to have large coronary artery fistula arising from right coronary artery and terminating into the main pulmonary artery.

Step up in Sats: RA 70%, PA 80% as expected given fistula. Cardiac surgery team felt that patient was deemed to be high risk to have a 2nd sternotomy within a year.

Images:

before and after coil embolization:

Garly Rushler Saint Croix

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