The case of a patient with right coronary artery-right atrial fistula was reported, with special reference to the noninvasive evaluation. On two-dimensional echocardiography in the short axis view, it was observed that the fistula had an entrance from the right coronary cusp, with the body of fistula sigmoid-like appearance running along the tricuspid ring and atrioventricular groove. In the subxyphoidal approach the exit of fistula into the right atrium was demonstrated. Intrafistular blood flow and drainage flow into the right atrium were identified by color flow mapping. The potential usefulness of the combination of two-dimensional, pulsed Doppler echocardiography and color flow mapping were discussed.
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