Right coronary artery fistula to the coronary sinus: Morphological and functional assessment by multidetector computed tomography and magnetic resonance flow measurement

Coronary artery fistulas are rare acquired or congenital abnormalities leading to a shunt between a coronary artery and one of the cardiac cavities, a main artery, or a vein. This case report describes the combined use of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the precise anatomical and functional assessment of a right coronary artery (RCA) fistula shunting to the coronary sinus. The RCA itself showed a massively elongated deformation and a maximal aneurysmatic dilatation of 41 mm on MDCT and MRI. The absolute shunt volume calculated by MRI flow measurements at the RCA was 40 ml, which means 37% in relation to the measured LV stroke volume of 109 ml.