Large coronary artery fistulas draining to the left heart structures causing heart failure are very rare. Interventional closure of such fistulas is limited to isolated reports, often in asymptomatic patients. Technical differences in these interventions include either deep arterial cannulation till their exit or transseptal arteriovenous circuit formation. Transcatheter closure of three large symptomatic fistulas in small children is reported.
Keywords: Coronary artery fistula; aortic run-off; device closure; heart failure.