title: Undiagnosed coronary fistula causing low cardiac output syndrome after pediatric heart surgery.
abstract: A patient with preoperative pulmonary hypertension and a large left to right intracardiac shunt underwent surgical correction of a complex cardiac anomaly and required extracorporeal life support for unexplained ventricular dysfunction following the procedure. Following recovery, a fistulous connection between the right coronary artery and main pulmonary artery was demonstrated. Implications and management strategies of unsuspected coronary fistula in pediatric heart surgery are discussed.
authors.affiliation: Pediatric Heart Center, UCSF Children's Hospital, Division of Pediatric Cardiothoracic Surgery, 513 Parnassus Avenue, Suite S-549, Box 0117, San Francisco, CA 94143-0117, USA.
authors.forename: Nelson
authors.initials: N
authors.lastname: Alphonso
authors.forename: Petros V
authors.initials: PV
authors.lastname: Anagnostopoulos
authors.forename: Anthony
authors.initials: A
authors.lastname: Azakie
authors.forename: Tom R
authors.initials: TR
authors.lastname: Karl
mesh_terms: D001159:Arterio-Arterial Fistula / Q000150:complications* / Q000175:diagnosis; D002303:Cardiac Output, Low / Q000209:etiology*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000175:diagnosis; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000002:abnormalities*