Abstract
Background: We describe a giant right coronary artery (RCA) to coronary sinus (CS) fistula in a 59-year-old woman who presented to our institution with right heart enlargement. Methods: Investigation revealed an ectatic 22mm RCA draining into an enlarged CS, and a Qp:Qs of 2.0. We proceeded with surgery. After initiating cardiopulmonary bypass and electrical arrest, the distal RCA was opened. An opening into the CS was confirmed and closed with a bovine pericardium patch. The RCA origin was triply ligated. Anastomoses of a saphenous vein graft to the posterior descending artery and the right ventricular marginal artery were performed, followed by anastomosis to the ascending aorta. Results: Post-operatively, mixed venous oxygen saturation was 76%. Six months later the patient was doing well. Conclusion: Coronary artery fistulas are rare congenital anomalies for which the ideal management strategies remain under study, with surgical repair being the mainstay of treatment in complex, aneurysmal fistulas.
Original language | English (US) |
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Pages (from-to) | 1405-1407 |
Number of pages | 3 |
Journal | Journal of cardiac surgery |
Volume | 37 |
Issue number | 5 |
DOIs | |
State | Published - May 2022 |
Keywords
- congenital heart disease
- Animals
- Coronary Sinus/diagnostic imaging
- Cattle
- Heart Defects, Congenital
- Humans
- Middle Aged
- Coronary Vessel Anomalies/surgery
- Female
- Coronary Artery Disease/surgery
- Fistula/surgery
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- Surgery