Circumflex to right lung fistula embolization for acute coronary syndrome secondary to steal syndrome: a case report

Unilateral absence of a pulmonary artery is a rare congenital abnormality with few reports in the literature demonstrating resultant myocardial ischaemia.

A 59-year-old presented with acute coronary syndrome (ACS). She was known to have right-sided pulmonary atresia. She was found to have angiographically normal looking coronary arteries but had left circumflex to right lung (via bronchial artery) fistula. Stress echocardiography demonstrated significant ischaemia in that territory, which resolved after coil embolization of the fistula.

To our knowledge, this is the first reported case of ACS secondary to steal phenomena due to circumflex-pulmonary fistula and treated successfully with coil embolization.