Congenital Bilateral Coronary-to-Pulmonary Artery Fistulas

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Congenital Bilateral Coronary-to-Pulmonary Artery Fistulas Andrew S Olearchyk, Dianne M Runk, Mosen Alavi, Michael A Grosso The Annals of Thoracic Surgery Volume 64, Issue 1, Pages 233-235 (July 1997) DOI: 10.1016/S0003-4975(97)00347-0

Fig. 1 Cardiac catheterization and coronary angiography of the right coronary artery in the right anterior oblique projection. It shows one of two coronary-to-pulmonary artery fistulas: this one originated from the very proximal right coronary artery and ascended up toward the anterior aspect of the main pulmonary artery with an entry into it. The Annals of Thoracic Surgery 1997 64, 233-235DOI: (10.1016/S0003-4975(97)00347-0)

Fig. 2 Selective injection of dye into the left main coronary artery in the right anterior oblique projection shows a markedly enlarged left main coronary artery with a dilated and tortuous second fistula originating from its distal portion, passing toward the anterior aspect of the pulmonary artery, where it formed an extensive malformation with an entry into that artery. The left anterior descending artery and circumflex artery were of normal diameter and not diseased. The Annals of Thoracic Surgery 1997 64, 233-235DOI: (10.1016/S0003-4975(97)00347-0)

Fig. 3 Selective injection of dye into the left main coronary artery in the left anterior oblique projection, showing a coronary-to- pulmonary artery fistula between the left main coronary artery and the anterior aspect of the main pulmonary artery with an extensive malformation entering that artery. The Annals of Thoracic Surgery 1997 64, 233-235DOI: (10.1016/S0003-4975(97)00347-0)

Fig. 4 Operative photograph after a median sternotomy and longitudinal opening of the pericardium showing bilateral coronary-to- pulmonary artery fistulas. One fistula originated from the very proximal right coronary artery and the other, tortuous, from the distal left main coronary artery. Both fistulas ascended toward the anterior aspect of the main pulmonary artery and formed an extensive malformation with entries into that artery. The Annals of Thoracic Surgery 1997 64, 233-235DOI: (10.1016/S0003-4975(97)00347-0)