The image in this vignette helps to illustrate a rare, albeit reported, complication of endomyocardial biopsy. The case was discussed by the heart team. Fistula occlusion with microcoils was considered; however, the patient was asymptomatic and presented no reduction of left ventricular ejection fraction, and the documented ischemia was minor. Therefore, the patient received conservative treatment.
Keywords: coronary fistula; endomyocardial biopsy.