Objective To report our experience in using the patent duct occluder for occlusion of giant coronary artery fistulae (CAF).   Methods Using echocardiogram and selective coronary arteriography

we diagnosed giant CAF from the right coronary artery to the right ventricle in a 43-year-old female. An arteriovenous wire loop was established via the aorta

coronary artery

and fistula to the right ventricle

right atrium and inferior vena cava. A long sheath was delivered antegradely to deploy the occluder in the CAF via the venous system.   Results The CAF was occluded completely. No residual shunt or other complications were observed during the 4-month follow-up.   Conclusion Transcatheter closure of giant coronary artery fistulas with patent duct occluder is feasible and safe in the anatomically suitable vessels.