title: Internal mammary to pulmonary artery fistula presenting as early recurrent angina after coronary bypass.
abstract: A 50-year-old man developed recurrent angina 1 year after coronary artery bypass surgery. The patient was found to have a large fistula involving branches of the internal mammary artery graft and the left pulmonary artery. In the absence of another clear cause for the patient's symptoms, we speculated that our patient's angina and abnormal stress nuclear study were due to coronary steal. In patients with a history of coronary bypass grafting, fistula formation between graft and native vessels should be considered as a possible cause of early recurrent angina.
authors.affiliation: University of Miami Cardiovascular Center, Miami, FL 33101, USA.
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Ferreira
authors.forename: Eduardo de
authors.initials: Ed
authors.lastname: Marchena
authors.forename: Michelle
authors.initials: M
authors.lastname: Liester
authors.forename: Afolabi O
authors.initials: AO
authors.lastname: Sangosanya
mesh_terms: D000787:Angina Pectoris / Q000209:etiology* / Q000601:surgery; D001159:Arterio-Arterial Fistula / Q000175:diagnosis / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008323:Mammary Arteries; D008875:Middle Aged; D011651:Pulmonary Artery; D012008:Recurrence