Bilateral coronary-to-pulmonary artery fistulas are extremely rare in congenital malformation among coronary artery fistulas. We reported two cases with symptomatic cardiac dysfunction were treated successfully by therapeutic transcatheter embolization. Two patients with bilateral coronary-to-pulmonary artery fistulas were admitted to our hospital. Patient 1 showed the reduced left ventricular diastolic function. Patient 2 showed a reduced left ventricular systolic function with moderate

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... ry hypertension and severe tricuspid regurgitation. ECG showed a pacing ECG with the complete right bundle branch block, anterior wall myocardial infarction, anterior wall and inferior wall cardiac ischemia as well as enlarged cardiac silhouette in its Chest X-ray. Coronary angiography revealed bilateral tortuous coronary fistulas originated from the left anterior descending artery and the right coronary artery in both patients, and drained into the main pulmonary artery. The two patients were treated successfully by therapeutic transcatheter embolization. We considered that selected transcatheter closure of coronary artery fistulas is a minimal invasive and feasible treatment in the presence of heart failure. Clinical and cardiac assessment should be done before transcatheter closure.