[Small fistulas between circumflex coronary artery and left atrium associated with rheumatic valvular cardiomyopathy. A case report (author's transl)].

Multiple small fistulas between the circumflex coronary artery and the left atrium were found in a patient with mitral stenosis, aortic and tricuspid regurgitation. Although their origin was proximal and they drained in a low pressure cavity, the anomalous channels were small and caused no clinically recognizable signs or symptoms. These findings support the view that hemodynamics (and hence clinical manifestations) of coronary artery fistulas are mainly determined by their developmental anatomy.