A complex coronary artery fistula with aberrant mediastinic and abdominal feeding arteries and pulmonary artery drainage.

Coronary artery fistulas are rare congenital malformations that can originate from anywhere in the coronary artery system and terminate in any of the cardiac chambers, great veins or pulmonary arteries. We illustrate the unique case of a multidetector computed tomography coronary angiography scan of a young man, showing a complex coronary fistula between the left anterior descending coronary artery and a branch of the left pulmonary artery (with drainage function) with adjunctive mediastinic and abdominal aberrant feeding arteries arising, respectively, from the left internal mammary artery and the celiac trunk.