Coronary artery fistula (CAF) is a direct
communication between a coronary artery and the lumen of any of the cardiac
chambers, i.e. the coronary sinus, the pulmonary artery, the
superior vena cava or the proximal pulmonary veins. The majority of these fistulas
are congenital in origin although they may occasionally be detected after
cardiac surgery. Congenital CAF is a rare anomaly and aneurysmal formation in
the fistula is even rarer. Majority of CAFs are isolated lesions, however, congenital or
acquired heart diseases may co-exist. Herein, we report a case of huge congenital
aneurysmal right CAF connected to the right atrium in an Iraqi man of 62
associated with tuberculous effusive-constrictive pericarditis to whom off pump
pericardiectomy was performed followed by ligation of right coronary artery and
vein graft implantation to its posterior descending branch under
cardiopulmonary bypass. To the best of our knowledge, such association was not
previously reported. CAF can be repaired surgically with minimum risk and
excellent outcome. Surgery is advised whenever coronary fistula is diagnosed
unless it is very small to avoid the potential complications.
Cite this paper
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