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A Case of Ventriculo‐venous Communication: An Extremely Rare Congenital Anomaly of the Left Ventricle

A 56-year-old man underwent coronary angiography because of exertional angina pectoris (New York Heart Association Class-II). He had a history of arterial hypertension for 5 years. All coronary arteries were normal on coronary angiography. On left ventriculography, a rapid filling of a cardiac vein through a primitive myocardial tract terminating in the coronary sinus was observed (Fig. 1A, B). There was a step-up in oxygen saturation at the level of the right atrium with a systemic to pulmonary flow ratio of 1:1.5. He was treated medically and antibiotic prophylaxis was offered. He was asymptomatic at six-months follow up.