Interv Akut Kardiol. 2002;1(1):50-54

Surgical treatment of coronary artery aneurysm-to-right atrium fistula

Michal Semrád¹, Petr Bodlák¹, Martin Stříteský¹, Vladimír Vondráček¹, Jan Vojáček^2,3, Petr Hájek³, Jaroslav Lindner¹, Jan Kunstýř¹, Ivan Vaněk¹

¹ II. chirurgická klinika kardiovaskulární chirurgie 1. LF UK a VFN, Praha

² I. interní klinika Fakultní nemocnice v Hradci Králové

³ Kardiocentrum dospělých, oddělení invazivní kardiologie interní kliniky 2. LF UK a FN Motol, Praha

52-year-old female with a marked left-to-right shunt (Qp/Qs = 2,72) due to circumflex coronary artery aneurysm-to-right atrium fistula and congestive heart failure was indicated for surgery. Operative management involved proximal pericardial patch occlusion of circumflex artery aneurysm transluminally through the dilated left main coronary artery stem, leaving left anterior descending (LAD) and intermedius (IM) branch ostium intact and followed by distal circumflex coronary artery-to-coronary sinus fistula ligation. A left internal mammary artery (LIMA) – LAD coronary artery bypass was performed to secure a perfect flow through LAD. Follow-up angiography 2 months after operation showed total occlusion of the fistula and circumflex artery aneurysm, patent LAD and IM branches with intact native ostia and only proximal part of LIMA – LAD bypass contrast filling. Although the postoperative course was not uneventful, finally the patient is symptom-free and leading an active life.

Keywords: coronary artery fistula, coronary artery aneurysm.

Published: December 31, 2002  Show citation