[A successful treatment of coronary arteriovenous fistula with Symbas procedure]

A successful treatment of coronary arteriovenous fistula with intraoperative echocardiogram and Symbas procedure is presented. The patient, a 2-year-old male, had been suffering from concealed congestive heart failure from his birth. The cardiac catheterization and angiogram revealed coronary arteriovenous fistula from LAD to right ventricle with large coronary aneurysm. In the operation, no fistula vessels were noted on the cardiac surface. Then, the intraoperative echocardiography was performed, and the fistula pour into right ventricle with aneurysm was found in the myocardium. The fistula was closed with Symbas procedure, and excellent closure could be checked with the intraoperative echocardiogram, too. After this operation, he got well under anticoagulant treatment with "ticlopidine".