Multiple fistulae of coronary arteries to both ventricles.

A 74 year old man was found at necropsy to have multiple coronary arteriosystemic fistulae involving all three major coronary arteries and both ventricles. This is the second such case reported. All terminal branches of the coronary arteries entered the myocardium and numerous tiny vessels opened into the cardiac chambers. No coronary veins or coronary sinus were recognized. This vascular anomaly is considered to result from the abnormal persistence of intertrabecular spaces within the embryonic myocardium.