Coronary Steal Caused by a Rare Left Circumflex– Pulmonary Artery Fistula: A Diagnostic and Therapeutic Challenge — A Case Report from Ain Al Khaleej Hospital

Laith Mohamad Bani Hamad*, Ashraf Al Azzoni, Waleed Mubarak

Specialist Interventional Cardiology, Ain Al Khaleej Hospital, Abu Dhabi

^*Correspondance to: Laith Mohammad Hamad 

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Abstract:

Coronary artery fistulas are rare congenital anomalies but may be associated with significant clinical consequences, including myocardial ischemia secondary to the coronary steal phenomenon. The reported incidence of coronary artery fistulas is 0.1–0.2% among patients undergoing coronary angiography, with less than 5% being LCx–PA fistulas. We describe a case of a 39-year-old male presenting with exertional angina and dyspnea, in whom a large, tortuous fistula originating from the left circumflex artery into the main pulmonary artery was identified. A comprehensive diagnostic workup confirmed coronary steal physiology. The patient then underwent successful transcatheter coil embolization at Cleveland Clinic Abu Dhabi, with which he achieved complete symptomatic resolution and normal echocardiographic findings on follow-up.

Keywords:

Coronary steal phenomenon, Coronary artery fistula, Left circumflex artery, Pulmonary artery, Coil embolization, Transcatheter closure

Cite the Article:

Hamad LMB, Al Azzoni A, Mubarak W. Coronary Steal Caused by a Rare Left Circumflex–Pulmonary Artery Fistula: A Diagnostic and Therapeutic Challenge — A Case Report from Ain Al Khaleej Hospital. Ann Clin Case Rep. 2025; 10: 2807..