Percutaneous closure of a large coronary fistula in a neonate.

A large coronary artery fistula originating from the circumflex artery and draining into the right atrium was diagnosed in an asymptomatic neonate on the first day of life. Over the following days, the patient developed pulmonary overcirculation and electrocardiographic signs of myocardial ischaemia. A successful percutaneous closure procedure was performed via a retrograde aortic approach using an Amplatzer Piccolo Occluder 5/4.