Percutaneous management strategies for STEMI with coexisting aneurysmal coronary- to-pulmonary artery fistula: a case report

Coexistence of coronary artery fistulas and atherosclerotic coronary artery disease (CAD) is rare.

We present a unique case of a patient initially presenting with an anterior ST-elevation myocardial infarction, subsequently found to have two-vessel CAD and an aneurysmal left coronary-to-right pulmonary artery fistula.

After discussion with the patient and a multidisciplinary discussion with the heart team, consisting of cardiovascular surgery, interventional cardiology, and vascular surgery, a percutaneous approach was chosen. He underwent successful multivessel percutaneous coronary intervention followed by fistula embolization.