Coronary Artery Fistulas: algorithmic approach to diagnosis and management

Coronary Artery fistulas (CAF) are rare yet clinically significant congenital or acquired connections between coronary arteries and cardiac chambers or vessels. Their diverse anatomy and presentation pose significant management challenges in the absence of strong evidence and definitive guidelines. This article reviews our current understanding and standard of care for coronary fistulas and highlights a proposed new algorithmic approach to diagnosis and management prioritizing non-invasive imaging and ischemia assessment.