Coronary artery fistula with left or right ventricular communication and sinus-node dysfunction

Coronary artery fistulae that communicate with the left ventricle are quite rare; those accompanied by sinus-node dysfunction are even more unusual. We report 2 cases of congenital coronary-artery-to-left-ventricle fistula with sinus-node dysfunction. In each of these patients, fistulae arose from both left and right coronary arteries. One patient had, in addition, a right coronary artery fistula that communicated with his right ventricle. Sinusnode dysfunction encountered in these 2 patients was likely caused by chronic general ischemia arising from a steal syndrome associated with the fistulae.