[Bilateral coronary-pulmonary artery fistulae without cardiopulmonary bypass]

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Medical Imaging

Background:

• Patent ductus arteriosus is a common congenital heart defect, but coronary artery fistulae are rare anomalies.
• Heart failure can be a presenting symptom of significant coronary artery fistulae.
• Surgical intervention is often necessary for symptomatic coronary artery fistulae.

Observation:

• A 68-year-old female presented with heart failure, initially suspected as patent ductus arteriosus.
• Coronary arteriography identified coronary artery fistulae originating from both coronary arteries.
• The patient underwent surgical excision of the fistulae without cardiopulmonary bypass.

Findings:

• Successful surgical excision of coronary artery fistulae was achieved.
• The patient experienced significant improvement in heart failure symptoms for 6 years post-surgery.
• Multidetector-row computed tomography (MD CT) proved useful for perioperative fistula detection.

Implications:

• Surgical intervention without cardiopulmonary bypass is a viable and effective treatment for coronary artery fistulae.
• This approach may offer a less invasive option for managing complex coronary artery anomalies.
• MD CT is a valuable tool for the diagnosis and perioperative assessment of coronary artery fistulae.