Coronary Artery Fistula§

Coronary artery fistula is an uncommon cardiac anomaly. One-hundred and seventy-two cases without either aortic or pulmonary valve atresia have been documented in the literature by 1969. In this paper, four further cases as seen in Singapore are described. The anterior descending branch of the left coronary artery was involved in two cases, and the left circumflex and right coronary artery in one case each. The right atrium and the right ventricle was the recipient chamber in two cases each. One of the four patients, an 11 -year-old Indian boy who presented with ischae-mic pain, was operated and improved remarkably after surgery. The clinical presentation, the investigations and the indications for operation in patients with coronary artery fistula are discussed in this paper.