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A. Coronary angiography: critical stenosis of the marginal branch (arrow); B. Coronary angiography: successful percutaneous coronary intervention of marginal branch (arrow); C, D. Coronary angiography: coronary artery fistula (CAF; arrow); E. Echocardiography study : suprasternal view of long axis of right pulmonary artery (RPA) : color flow Doppler images: CAF flow (arrow); F. Echocardiography study : suprasternal view of long axis of RPA : pulsed-wave Doppler: CAF flow (arrow) : sample volume in the RPA; Ao : aortic arch.
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Coronary angiography revealed a critical stenosis of a marginal branch (Fig. 1A) and coronary artery fistula (CAF) originating from the left main coronary artery (Fig. 1C, D). A successful percutaneous coronary intervention of the marginal branch with drug-eluting stent implantation was performed (Fig. 1B). A repeat careful echocardiographic examination was able to detect flow to the right pulmonary artery (Fig. 1E, F).