Spontaneous near closure of coronary artery fistula.

An asymptomatic 14-year-old male was found at cardiac catheterization to have a coronary artery fistula involving a vessel originating from the left main coronary artery and terminating in the right heart. Chest X-ray and electrocardiogram were within normal limits and shunt flow was too small to be detected by oximetry although a large vessel was seen angiographically. One year later, the previously loud continuous murmur had disappeared and repeat catheterization demonstrated near closure of the fistula. This is the first report documenting the spontaneous closure of a coronary artery fistula.