title: Congenital aortopulmonary artery fistulas combined with bilateral coronary artery fistulas.
abstract: We describe an extremely rare case of "congenital aorto-pulmonary artery fistulas" combined with bilateral coronary artery fistulas associated with clinically significant left-to-right shunt. A multi-detector row computed tomographic scan revealed that tortuous anomalous vessels arising from the aortic arch, left anterior descending coronary artery, diagonal branch, and right coronary artery were connected to the main pulmonary trunk. After surgical intervention, the systemic-to-pulmonary flow ratio nearly normalized from 2.02 to 1.05. We describe the case and speculate as to the embryological pathogenesis of these unique fistulas.
authors.affiliation: Department of Cardiovascular Surgery, Fujisawa City Hospital, Fujisawa-City, Kanagawa, Japan. gogomotto@livedoor.com
authors.forename: Motohiko
authors.initials: M
authors.lastname: Goda
authors.forename: Kentaro
authors.initials: K
authors.lastname: Arakawa
authors.forename: Hideto
authors.initials: H
authors.lastname: Yano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Himeno
authors.forename: Ichiya
authors.initials: I
authors.lastname: Yamazaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000015:Abnormalities, Multiple; D000369:Aged, 80 and over; D000792:Angiography; D001013:Aorta, Thoracic / Q000002:abnormalities*; D001159:Arterio-Arterial Fistula / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D001807:Blood Vessel Prosthesis; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011651:Pulmonary Artery / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed