CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2020; 09(01): e9-e10
DOI: 10.1055/s-0040-1702212
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

Coronary Artery Fistula Unmasking the Absence of Left Pulmonary Artery in an Adult

Holger H. Sigusch
1  Division of Cardiology, Department of Internal Medicine, Heinrich-Braun-Klinikum, Zwickau, Germany
Andreas Hansch
2  Department of Radiology, Interventional Radiology and Neuroradiology, Heinrich-Braun-Klinikum, Zwickau, Germany
Torsten Doenst
3  Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany
› Author Affiliations
Further Information

Publication History

28 October 2019

13 December 2019

Publication Date:
21 March 2020 (online)


Coronary artery fistulae are an incidental finding in patients undergoing coronary angiography or computed tomography (CT) coronary angiography. A 60-year-old man with known coronary artery disease presented with dyspnea. Coronary angiography revealed a large fistula arising from the circumflex artery (CX) without a clear intrathoracic target vessel or chamber in the heart. CT angiography revealed the agenesis of the left pulmonary artery. The fistula arising from the CX ensured left lung tissue supply. Unilateral absence of a pulmonary artery is an extremely rare condition. In this case, the identification of a fistula from the heart triggered the correct diagnosis.