CTICasesRight Coronary Artery to Superior Vena Cava Fistula
Imaging findings
Coronary CT angiography shows a massively dilated right coronary artery (RCA) with a large collateral branch draining directly into the lower portion of the superior vena cava (SVC), associated with right ventricular volume overload and diastolic septal flattening.
Key takeaways
Coronary artery fistulas are rare congenital anomalies. An RCA-to-SVC fistula leads to a left-to-right shunt. When the shunt is large, it causes volume overload of the right heart chambers, presenting as right ventricular hypertrophy, dilation, and diastolic septal flattening, requiring surgical ligation or coil embolization.
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