Three main coronary arteries to pulmonary artery fistula.

A case of a 19-year-old woman with coronary artery fistula was reported. She was asymptomatic throughout her life. Physical examination revealed a continuous murmur along the left sternal border. Echocardiograms and left ventriculograms showed mitral valve prolapse. Selective coronary arteriograms disclosed arteriovenous fistula between branches of the right, the left anterior descending and the left circumflex coronary artery and the main pulmonary trunk. We believe that this is the first case report of an unusual form of anomalous coronary-pulmonary artery communication: three main coronary vessels participate in the fistula.