Surgical intervention for bilateral coronary artery fistulas to the pulmonary artery.
A 60-year old female was referred to our institution for surgical intervention to treat bilateral coronary artery fistulas to the pulmonary artery (PA). Multidetector computed tomography (MDCT) imaging showed two tortuous vessels with multiple aneurysmal dilatations originating from the right coronary artery and left anterior descending artery. Furthermore, oximetry revealed an oxygen step-up of 10% between the PA and the right ventricle, consistent with an estimated left-to-right shunt of 47.1%, indicating that the patient was a candidate for surgery. Under heart arrest, the main PA was longitudinally opened and a single efferent hole sized 10 mm in diameter located in the anterior sinus of the pulmonary trunk was closed. Thereafter, the two afferent vessels were individually ligated at their proximal origins. Postoperative MDCT demonstrated no evidence of abnormal vessel communication between the coronary arteries and the PA, as well as relatively dilated native coronary arteries when compared with the preoperative state. At the 6-month follow-up examination, the patient was asymptomatic and showed no complications.
Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization, Osaka Rosai Hospital, Sakai, Osaka, Japan.
Satoshi
S
Kainuma
Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization, Osaka Rosai Hospital, Sakai, Osaka, Japan.
Toshihiro
T
Funatsu
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Yoshiki
Y
Sawa
Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization, Osaka Rosai Hospital, Sakai, Osaka, Japan kataniguchi1953@gmail.com.
Kazuhiro
K
Taniguchi
D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging / Q000601:surgery; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery
Coronary artery fistula; Multidetector computed tomography; Pulmonary artery