Coronary artery fistulas: case report and review of literature.

Congenital coronary artery fistula is a very rare malformation that may involve any or all coronary artery branches and any cardiac chamber. Elective closure of coronary artery fistulas by surgery or percutaneous transcatheter techniques is generally accepted in the presence of symptoms, but controversies exist in the management of asymptomatic patients. We describe a case where a fistulous communication was present between the proximal left anterior descending coronary artery and the pulmonary artery and provide a review of the available literature concerning management of patients with coronary artery fistulas.