Surgical treatment of multiple coronary artery fistulas with an associated small saccular aneurysm--a case report.
Coronary angiography (CAG) of a 57-year-old woman with anterior chest discomfort revealed no stenosis of the coronary arteries but multiple coronary artery fistulas (CAFs). The sites of origin for the CAFs were the right coronary artery, left main coronary artery, left anterior descending coronary artery, and ascending aorta. The only site for drainage was the main pulmonary artery. Furthermore, a small saccular aneurysmal formation was detected. Surgical treatment was considered better than conservative treatment or coil embolization, and ligation and division of the CAFs were performed during cardiopulmonary bypass. Using a Harmonic Scalpel to expose fistulous arteries was very effective. CAG performed immediately after surgery demonstrated that all CAFs were repaired. The postoperative course was uneventful.
Fujii
Hiromichi
H
Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Shinbo, Fukui, Japan. fujiihiro@msic.med.osaka-cu.ac.jp
Tsutsumi
Yasushi
Y
Ohashi
Hirokazu
H
Kawai
Takahiro
T
Iino
Kenji
K
Onaka
Masateru
M
D001011:Aorta / Q000473:pathology / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001159:Arterio-Arterial Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003323:Coronary Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome