Atypical chest pain due to multiple coronary arteries fistulas occluded with percutaneous interlock coils: A case report.

Coronary artery fistulas, although rare, should be included in the differential diagnosis of atypical chest pain, generally unveiled by cardiac catheterization or multidetector computed tomography. Such anatomical findings in conjunction with detectable ischemia and severe symptoms should prompt their closure. Transcatheter closure of fistulas is an attractive alternative to surgery, especially with the novel devices such as the interlock fibered detachable coils, which can be safely and effectively performed in a variety of circumstances, including the coronary arteries with tortuous anatomies. We present a case of atypical chest pain and large burden of ischemia in the stress scintigraphy, due to multiple coronary fistulas to the bronchial arteries successfully occluded with percutaneous interlock coils. <Learning objective: This report describes the feasibility and safety of multiple tortuous coronary-bronchial fistulas treated with the novel interlock fibered detachable coils, in a patient with prior thromboembolism. This is the first case report to use this device in this situation and shows that, in symptomatic patients with documented ischemia, such novel devices may help in treating coronary fistulas, even in tortuous anatomy.>.