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Congenital Coronary Arteriovenous Fistula

FRANCIS A. PUYAU, MD; HAROLD A. COLLINS, MD
Am J Dis Child. 1963;106(1):65-72. doi:10.1001/archpedi.1963.02080050067012.
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Congenital coronary arteriovenous fistulae, rare anomalies, have become the subject of much investigation in recent years because of the interesting physical findings and extensive modern application of cardiac catheterization, and more recently, angiocardiographic techniques which have been used to work out the pathophysiology.1-5 Diagnosis is important because this anomaly can be successfully treated surgically with an extremely low mortality and without the use of hypothermia or extracorporeal circulation. Usually the fistula communicates with the right atrium, right ventricle, or pulmonary artery and produces a left-to-right shunt. In unusual instances the fistula may communicate with the left atrium or left ventricle. The hemodynamic consequences of such fistulae are dependent upon the size of the shunt, age of the patient and coexistent abnormalities, while complications include bacterial endarteritis, myocardial ischemia, and rupture of the aneurysm. The purpose of this article is to describe a child with a coronary right-ventricular fistula and the

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