Incidental Detection of Left Anterior Descending Artery-Main Pulmonary Artery Fistula.
Soham M Jarande, Rajshree Uttamrao Dhadve
✦ AI-curated · Sources linked
Case in brief
A 52-year-old man undergoing evaluation for suspected coronary artery disease had CT coronary angiography showing a small fistulous connection between the left anterior descending artery and the main pulmonary artery. Imaging also showed absence of the left main coronary artery, with separate origins of the left anterior descending and left circumflex arteries. He remained asymptomatic and had no significant hemodynamic compromise; conservative management was considered appropriate.
What made this case unusual
The incidental fistula was accompanied by a separate coronary-origin anomaly: the left anterior descending and left circumflex arteries arose independently in the absence of a left main coronary artery.
Diagnostic / clinical pearl
CT coronary angiography can identify incidental coronary fistulas and associated coronary-origin anomalies, helping characterize findings when symptoms or significant hemodynamic compromise are absent.