[Bilateral coronary-pulmonary artery fistula and accessory vascular connection of the thoracic aorta to the right lower pulmonary artery]. / Bilaterale koronar-pulmonalarterielle Fisteln und akzessorische Gefässverbindung der thorakalen Aorta zur rechten unteren Pulmonalarterie.

ABSTRACT

A 41-year-old man presenting with atypical chest pain was admitted to hospital with suspected pericarditis after a common cold disease. A complex risk profile for arteriosclerotic coronary artery disease was taken into account in differential diagnosis. Cardiac catheterization revealed large bilateral coronary artery-pulmonary artery fistulas as well as an accessory vessel with origin of the thoracic aorta both draining into the lower right pulmonary artery. The vessel anomalies showed a remarkable plexus-like morphology before entering into the pulmonary artery. Arteriosclerotic coronary artery disease was not found. No evidence of myocardial ischemia was found in the furthermore asymptomatic patient, therefore surgical correction of the vessel anomalies was not performed. To our knowledge the present case report represents the first case with bilateral coronary artery-pulmonary artery fistulas and an accessory communication of the thoracic aorta to the pulmonary artery vasculature.