Coronary artery-bronchial artery fistulas: Report of two Dutch cases with a review of the literature

Abstract

Background Coronary bronchial artery fistulas (CBFs) are rare anomalies,whichmay be isolated or associated with other disorders. Materials and methods Two adult patients with CBFs are described and a PubMed search was performed using the keywords "coronary bronchial artery fistulas" in the period from 2008 to 2013. Results Twenty-seven reviewed subjects resulting in a total of 31 fistulas were collected. Asymptomatic presentation was reported in 5 subjects (19%), chest pain (n=17) was frequently present followed by haemoptysis (n=7) and dyspnoea (n= 5). Concomitant disorders were bronchiectasis (44%), diabetes (33%) and hypertension (28%). Multimodality and single-modality diagnostic strategies were applied in 56% and 44%, respectively. The origin of the CBFs was the left circumflex artery in 61%, the right coronary artery in 36% and the left anterior descending artery in 3%. Management was conservative (22%), surgical ligation (11%), percutaneous transcatheter embolisation (30%), awaiting lung transplantation (7%) or not reported (30%). Conclusions CBFs may remain clinically silent, or present with chest pain or haemoptysis. CBFs are commonly associated with bronchiectasis and usually require a multimodality approach to be diagnosed. Several treatment strategies are available. This report presents two adult cases with CBFs and a review of the literature. © The Author(s) 2014.