title: Surgical treatment of multiple coronary artery fistulas with an associated small saccular aneurysm--a case report.
abstract: 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.
authors.affiliation: Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Shinbo, Fukui, Japan. fujiihiro@msic.med.osaka-cu.ac.jp
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Fujii
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tsutsumi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Ohashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawai
authors.forename: Kenji
authors.initials: K
authors.lastname: Iino
authors.forename: Masateru
authors.initials: M
authors.lastname: Onaka
mesh_terms: 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