Abstract
A 17-year-old male complained of exertional dyspnea and was referred to our hospital
after he was diagnosed with a right coronary artery fistula into the left ventricle.
Surgical repair was considered to improve the symptoms. We identified the distal end
of the right coronary artery entering the left ventricle under cardiopulmonary bypass
with cardiac arrest. The fistula was transected at the distal end of the right coronary
artery and closed at both ends without incision of the left ventricle. Coronary angiography
revealed the patency of the right coronary artery and the peripheral branches four
months after surgery. The coronary computed tomography four years and four months
after operation showed no pseudoaneurysm formation, no thrombosis, and subsequent
regression of the dilated right coronary artery.
Learning objective
The coronary artery fistula is a rare congenital anomaly, and the treatment strategies
of the coronary fistula are controversial. We performed ligation of the coronary fistula
under cardiac arrest on cardiopulmonary bypass without incision of the left ventricle.
This strategy may contribute to the accurate identification and ligation of the fistula
without pseudoaneurysm formation.
Keywords
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Article info
Publication history
Published online: January 07, 2023
Accepted:
December 10,
2022
Received in revised form:
November 13,
2022
Received:
July 9,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
