Coronary artery fistula: diagnosis by biplane transesophageal echocardiography.

A 56-year-old man underwent coronary angiography during evaluation of severe mitral regurgitation. A right coronary artery fistula was incidentally discovered but its site of termination was uncertain. Transthoracic echocardiography also did not reveal the location of its drainage. The correct diagnosis of a right coronary artery to left atrial fistula was made using biplane transesophageal echocardiography. This case demonstrates the utility of biplane transesophageal echocardiography in the diagnosis of the origin and termination of congenital coronary artery anomalies.