Two-dimensional and Doppler echocardiographic study of coronary arteriovenous fistulas.

Sixteen patients with coronary arteriovenous fistula (CAVF) were studied by two-dimensional echocardiography (2DE). Of these 12 had Doppler studies. In all, the diagnosis of CAVF was confirmed by aortic root or selective coronary angiography. In 8 patients, the 2DE findings suggested CAVF. Five patients had dilated main coronary arteries and in 4 patients abnormal fistulous channels were identified. Two had diastolic flutter of the tricuspid valve and one had spontaneous contrast in the right atrium. In 11 out of 12 patients, Doppler analysis picked up a continuous flow (to the right atrium in 5, right ventricle in 4 and to both ventricles in 2 patients) prior to the cardiac catheterisation. We conclude that noninvasive diagnosis of CAVF can be made with the combined use of two-dimensional and Doppler echocardiography in most of the patients.