Spontaneous near closure of coronary artery fistula: Doppler echocardiographic findings.

A 1-year-old girl was diagnosed as having a fistula between the left coronary artery and the right ventricle by selective coronary angiography. The left to right shunt ratio was 38%. At a second angiography, the fistula was markedly diminished in size. Turbulent flow was detected throughout the cardiac cycle in the left coronary artery and during systole in the right ventricle by Doppler echocardiography on the first visit. At 3 years of age the systolic component of the left to right shunt flow in the left coronary artery and the right ventricle was reduced in size. Doppler echocardiography proved useful in observing the natural history of this coronary artery fistula.