Fistule entre l'artère interventriculaire antérieure et l'artère pulmonaire : à propos d'un cas

Fistulas of the coronary arteries with cardiac chambers or with large vessels are rare entities. They can be congenital or acquired. They are usually asymptomatic, but can also cause various symptoms such as chest pain and dyspnea. Sudden deaths have been described in the literature. These malformations can be diagnosed fortuitously during coronary angiography, or more rarely through an autopsy. We report the case of an individual, who presented sudden weakness with an acute heart rhythm disorder, complicated by cardiac arrest. After resuscitation and stabilization, a coronary angiography was performed, allowing the identification of a fistula between the left anterior descending artery and the pulmonary artery. The clinical evolution was pejorative in view of the anoxic-ischemic complications with a passage in a state of brain death. It was decided to stop all the therapeutics. An autopsy was performed confirming the presence of fistula between the anterior interventricular artery and the pulmonary artery. Contribution of this malformation to death is then discussed by the authors.