Congenital left coronary artery - right ventricular fistula

The case of a neonate with heart failure and myocardial ischaemia due to a large coronary artery fistula is reported. ECG monitoring and Thallium - 201 imaging indicated pre-operative myocardial ischaemia. The diagnosis was confirmed by cardiac catheterization. Successful surgical ligation of the fistula was performed at the age of 10 days and to our knowledge is the first successful ligation in the neonatal period. Follow up Thallium - 201 imaging was normal. Repeat cardiac catheterization demonstrated complete closure of the fistula and normal left ventricular function.