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Successful percutaneous treatment of a mycotic right coronary to right ventricle fistula
  1. William Wilson,
  2. Ingibjorg Gudmundsdottir,
  3. Nicholas Cruden
  1. Department of Cardiology, Edinburgh Heart Centre, Edinburgh, UK
  1. Correspondence to Dr William Wilson, Department of Cardiology, Edinburgh Heart Centre, 51 Little France Crescent, Edinburgh EH145SA, UK; wmclwilson{at}

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A 70-year-old man presented with unstable angina with dynamic ECG changes in the setting of staphylococcal sepsis. His background includes end-stage renal failure requiring haemodialysis and coronary bypass grafting.

Coronary angiography confirmed patent left-sided grafts and a large fistula from the mid-right coronary artery (RCA) to the right ventricle (RV) (figure 1), causing a large left-to-right shunt and consequent steal phenomenon with RCA territory ischaemia. This fistula was not present at angiography 2 years prior and was …

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