Transthoracic Echocardiographic Demonstration of Coronary Artery to Right Ventricle Fistula Caused by Endomyocardial Biopsy

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A fistula between the septal perforator of the left anterior descending artery and the right ventricle was detected by transthoracic echocardiography in a patient with eosinophilic myocarditis who underwent an endomyocardial biopsy. This was a new finding, confirmed by coronary angiography, since a prior angiography taken seven months earlier. To the best of our knowledge, this is the first report that a combination of transthoracic color Doppler echocardiography and a high-frequency transducer will result in the detection of the coronary artery to the right ventricle fistula as a complication of endomyocardial biopsy.