title: [A successful surgical treatment of coronary to pulmonary artery fistula with coronary steal phenomenon due to large volume of shunt: a case report].
abstract: A successful surgical treatment of right and left coronary to pulmonary artery fistula was presented. The patient was 61-year-old female, who was admitted for evaluation of cardiac murmur and chest pain. Cardiac catheterization and coronary artery angiogram revealed a large fistula both from RCA and LAD to the main pulmonary artery and distal LAD flow was sealed by this fistula. The left to right shunt ratio was calculated to be 55.1%. Preoperative BMIPP scintigram showed low uptake in the apex of the heart. Operation was indicated, because it was considered that angina pectoris was originated from coronary steal phenomenon. At the operation each right and left coronary shunt flow was measured to be 100 ml/min respectively. The fistulas were ligated and an opening of fistulas draining into the main pulmonary artery was closed through pulmonary arteriotomy under total cardiopulmonary bypass. Postoperative angiogram showed complete disappearance of the fistulas, postoperative BMIPP scintigram became to be normal, and her chest pain disappeared.
authors.affiliation: Department of Cardiovascular Surgery, Yokohama Sakae Kyousai Hospital, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ikeda
authors.forename: N
authors.initials: N
authors.lastname: Ishikawa
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Sawa
authors.forename: N
authors.initials: N
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Tokuda
authors.forename: M
authors.initials: M
authors.lastname: Kawasuji
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: D000787:Angina Pectoris / Q000209:etiology*; D001159:Arterio-Arterial Fistula / Q000150:complications / Q000601:surgery*; D017023:Coronary Angiography; D003326:Coronary Circulation; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D008875:Middle Aged; D011651:Pulmonary Artery