title: Transesophageal echocardiography, more than a diagnostic tool: use during surgical ligation of coronary artery fistulae - a case report.
abstract: Coronary artery fistulae (CAF) are an infrequent coronary abnormality. Herein, we describe the use of intraoperative transesophageal echocardiography (TEE) in the treatment of CAF. A 61 year-old woman presented with chest pain and symptoms consistent with unstable angina. Subsequent coronary angiography revealed the presence of 2 CAF, one extending from the left anterior descending artery to the pulmonary artery (PA) and the other extending from the proximal right coronary artery to the PA. Surgical ligation of the CAF without coronary bypass was arranged. Intraoperative TEE was successfully employed to localize the CAF, monitor fistula blood flow and heart wall motion, and confirm successful ligation. The patient recovered without complications. This case highlights the utility of intraoperative TEE during ligation of CAF.
authors.affiliation: Department of Anesthesia, Pain Service, and Critical Care Medicine, China Medical University Hospital, No, 2, Yuh-Der Road, Taichung 404, Taiwan, ROC.
authors.forename: Ping-Chen
authors.initials: PC
authors.lastname: Chung
authors.forename: Pai-Ching
authors.initials: PC
authors.lastname: Huang
authors.forename: Yu-Fang
authors.initials: YF
authors.lastname: Liu
authors.forename: Kuen-Bao
authors.initials: KB
authors.lastname: Chen
mesh_terms: D001159:Arterio-Arterial Fistula / Q000151:congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D003324:Coronary Artery Disease / Q000151:congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008026:Ligation; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography