The exact incidence of CAF is as yet unknown because the undiagnosed rate still remains high. Most of the CAF is asymptomatic and diagnosed incidentally during the routine physical examination. For the CAF can bring about bad consequences at an older age, the early diagnosis and treatment are very important.
Cardiac catheterization is considered to be the gold standard for the diagnosis of CAF, it can not only detect the cardiac structural involvement, but also achieve an interventional closure with a proper device . Dual-source computed tomography (DSCT) has been widely used in clinical diagnosis of CAF because of its superiorities of short examining time, low radiation dose and excellent image quality . Except that DSCT cannot be used to treat CAF, DSCT can proved detailed structural information about the fistula and concomitant cardiac malformations which are helpful for the therapeutic decision making. Echocardiography is the most common imaging modality for CAF owning to its repeatable and noninvasive features.
The treatment for these coronary fistula is depend on the characteristics of fistula and coronary artery, it include two main options: surgical or transcatheter technique . Simple CAF which means there is no coronary artery ectasia along the coronary that supply the fistula could be treated by transcatheter closure. Coronary artery aneurysm resulted from fistula is very rare and cannot be eliminated by transcatheter so that surgical repair is the optimal option. The surgical intervention through which we can close the fistula, meanwhile fix the dilated coronary artery to approximately its normal size. In this case we chose surgical repair due to the giant coronary artery aneurysm, the risk of aneurysm rupture and thrombosis could be reduced to the most extent.