Multiple Coronary to Bronchial Artery Fistulas Detected During Workup of a Young Patient with Cystic Fibrosis and Bronchiectasis for Lung Transplant

We report a rare case of multiple coronary bronchial artery fistulas in a 34-year-old young male with cystic fibrosis and bronchiectasis while he was actively being worked up for a lung transplant. He had atypical chest pain with compromised left ventricular ejection fraction on echocardiogram. Patients with longstanding bronchiectasis can have acquired anomalous connections from coronary arteries and have to be excluded before lung transplant or any major surgery, especially if they have cardiac symptoms or preliminary investigations are abnormal. Learning Objective: Our case report highlights that coronary artery bronchial artery fistulas are common in patients with longstanding bronchiectasis and need to be excluded before considering for any major surgical procedure either by MDCT or conventional coronary angiogram.