Closure of a coronary to pulmonary artery fistula by radiofrequency catheter ablation in the pulmonary artery

Sirs: Coronary to pulmonary artery fistulas are a rare finding with a wide range of clinical symptomatology [1, 2]. Since several decades the interventional embolization of the fistulas is the first-line treatment in symptomatic patients [3]. Different interventional techniques, such as ballonocclusion, coil or occluder implantation and implantation of covered coronary stents had been introduced [3, 4]. Despite a high success rate, in rare cases the specific morphology of the fistulas may be the cause for a failed intervention. In the present report, we describe a case of failed duct occluder implantation with a subsequent successful radiofrequency catheter ablation of the orifice of the fistula in the pulmonary artery. Case report