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Transesophageal Echocardiography for Pulmonary Artery to Left Atrial Fistula

The report of a rare case of right pulmonary artery (PA) to left atrial (LA) fistula by Faizal and colleagues1 is very interesting. The authors performed transthoracic echocardiography with contrast injection in a peripheral vein. According to them, immediate and dense opacification of the left atrium suggested a PA–LA fistula. In our experience, transesophageal echocardiography (TEE) gives a complete and better picture of the condition,2 highlighted in the case below.