Giant right coronary artery fistula to the coronary sinus: multimodal imaging

A 69-year-old man complaining of dyspnoea on moderate exertion was referred to our department due to a suspicion of right coronary artery (RCA) malformation based on transthoracic echocardiography. During transthoracic and transoesophageal echocardiography (TTE and TEE), we found a severe dilatation of the proximal part of RCA, vascular structure located near the free wall of his right ventricle and also posterior to the heart, increased, turbulent flow from the coronary sinus (CS) to right atrium (RA) and small atrial septal defect ( Panels …