Coronary Arteriovenous Fistula

Angiocardiography and physical findings established the diagnosis of a coronary arteriovenous aneurysm in a 6-year-old asymptomatic schoolgirl. During the 7 years that have ensued, her heart size, electrocardiogram, and general condition have remained normal. Review of the literature discloses 13 autopsy-proved coronary artery fistulas and 8 cases wherein the diagnosis was established by exploratory thoracotomy or cardiac catheterization. The data indicate a wide variation in the clinical significance of the lesion and lead to the conclusion that management is best established on an individual basis.