SURGICAL CLOSURE OF LEFT CORONARY ARTERY-LEFT VENTRICULAR FISTULA - 2ND CASE REPORTED IN LITERATURE AND A REVIEW OF 5 PREVIOUSLY REPORTED CASES OF CORONARY-ARTERY FISTULA TERMINATING IN LEFT-VENTRICLE

  • 1 January 1977
    • journal article
    • research article
    • Vol. 74  (2) , 199-203
Abstract
Surgical closure of a left coronary artery-left ventricular fistula in a 44 yr old black man is reported. The fistula was discovered by coronary arteriography after the patient was admitted to the hospital complaining of recurrent chest pain. The fistula was closed with cardiopulmonary bypass, ischemic arrest and hypothermia, and there was an uneventful postoperative recovery. The previously reported 5 cases of fistulas terminating in the left ventricle that were closed surgically are reviewed. Of these cases, 4 originated in the right coronary artery and 1 in the left coronary artery. Of the 6 patients, 3 were asymptomatic at the time of discovery of the lesion. Cardiopulmonary bypass was necessary in 5 of the 6 cases. One patient died in the postoperative period from intractable hemorrhage. Coronary artery fistulas should be closed upon establishment of the diagnosis because of the sequelae if they are allowed to remain open; these include premature atherosclerosis, aneurysmal dilatation of the coronary artery and congestive heart failure.

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