Diagnosis of a left coronary artery to right ventricular fistula with progression to spontaneous closure.

Coronary artery fistulas in structurally normal hearts are rare. The natural history of these lesions depends on their size and can cause congestive heart failure, infective endocarditis, ischemia, or accelerated atherosclerosis. These fistulas are usually closed either in the catheterization laboratory or surgically. This case demonstrates the prenatal diagnosis of a left coronary to right ventricular fistula and documents its natural history to spontaneous closure by 1 year of age. This may help confirm the rationale of observation rather than closure of small fistulas in selected cases of patients without symptoms.