Bilateral coronary to pulmonary artery fistulae--5 1/2 years of follow-up with conservative treatment.

Coronary artery fistulae are uncommon form of coronary anomalies, often diagnosed incidentally during coronary arteriography. Dual origin of fistulae from both coronary arteries draining into the pulmonary arterial branches is extremely rare and their natural history is unknown. In this report, we present a case of middle aged female with an incidental finding of bilateral coronary artery to pulmonary artery fistulae on coronary arteriography, which was followed clinically for 5 1/2 years with conservative treatment, remaining in NYHA class I to II with no symptoms directly related to her coronary artery fistulae.