[Evaluation of coronary artery fistula using a color Doppler flow imaging technique].

Two unusual cases with coronary artery fistula were reported. The diagnoses were first made by color Doppler flow imaging and confirmed by selective coronary angiography and operation. In the first case, color Doppler revealed a continuous flow signal within the dilated left coronary artery and a turbulent jet within the right atrium. In the second case, color Doppler showed turbulent flow signals which could be traced from the proximal left coronary artery, along the left ventricular posterior wall and into the left ventricle. The high velocities at the site of drainage of fistula were recorded by the continuous-wave Doppler and the calculated pressure gradient confirmed that the abnormal flow was from the systemic circulation. We are of the opinion that color Doppler flow imaging is a reliable technique for detecting coronary artery fistula and the combination of color Doppler with continuous-wave Doppler is essential for evaluating the hemodynamics of the shunt flow.