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December 14, 1963


JAMA. 1963;186(11):1031-1032. doi:10.1001/jama.1963.03710110083033

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Congenital Communications Between Coronary Arteries and the Atria.  —At the meeting of the Société Médicale des Hôpitaux de Paris on March 8, 1963, P. Soulié and co-workers reported on three fistulas they had observed between the right coronary artery and the right auricle. Clinically a constant murmur is found in the precordial area. That murmur is usually located at the lower right sternal border, and diagnosis is made by catheterization which confirms the impression of a left-right shunt. Retrograde aortography shows the characteristic picture.There exists the danger of cardiac insufficiency. One has to intervene, in order to prevent long-term damage from shunt and thus to avoid impairment of the involved coronary artery. Intervention is surgical, and the choice of the method to be used can be made only during surgical intervention. In those cases where the orifice of the communication affects the distal part of the coronary trunk or

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