title: Surgical management of the coronary artery to pulmonary artery fistulas; a case of a large ruptured aneurysm.
abstract: Three patients were treated for coronary artery-pulmonary artery fistula. Each was asymptomatic due to a coronary artery fistula. There was one instance each of myocardial infarction, mitral stenosis and a large closed ruptured aneurysm including a thrombus. All the fistulas were comprised of several small plexiform arranged vessels. The left to right shunt ratio was approximately 8 percent or less. A surgical operation was performed to close the drainage orifice of the fistulas through pulmonary arteriotomy under cardiopulmonary bypass in two patients while one patient underwent a ligation of a large abnormal vessel to the aneurysm followed by a resection of the aneurysm without cardiopulmonary bypass. A large saccular aneurysm of such fistulas is rare and a rupture of such an aneurysm is even more rare. The surgical management of coronary artery fistulas is also discussed herein.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, School of Medicine, University of Occupational & Environmental Health, Fukuoka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ishikura
authors.forename: S
authors.initials: S
authors.lastname: Odagiri
authors.forename: A
authors.initials: A
authors.lastname: Shimazu
authors.forename: D
authors.initials: D
authors.lastname: Hirao
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Yano
mesh_terms: D000328:Adult; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001159:Arterio-Arterial Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012422:Rupture, Spontaneous