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[Coronary artery-to-pulmonary artery fistula with aneurysm: two cases report]
1Department of Cardiovascular Surgery, Akita Medical Center, Japan.
Insights
Surgical resection of coronary artery-to-pulmonary artery fistula with aneurysms is recommended. Early intervention for coronary aneurysms can prevent rupture.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Thoracic Surgery
Background:
- Coronary artery-to-pulmonary artery fistula (CoPAF) is a rare condition.
- Aneurysmal dilatation associated with CoPAF poses a risk of rupture.
Observation:
- Two patients with CoPAF and aneurysms underwent surgical intervention.
- One patient had a fistula from the left coronary artery with three 2 cm aneurysms.
- The second patient had a fistula from both coronary arteries with a giant 7 cm aneurysm.
Findings:
- Surgical resection of the fistulas and aneurysms was successfully performed.
- Closure of drainage openings into the pulmonary artery was achieved using cardiopulmonary bypass.
- The procedures aimed to prevent potential aneurysm rupture.
Implications:
- Early resection of coronary aneurysms in patients with CoPAF is crucial.
- Surgical management can effectively treat complex CoPAF with aneurysms.
- This approach mitigates the risk of life-threatening complications such as rupture.
Abstract:
We performed the operation for coronary artery-to-pulmonary artery fistula with aneurysm in two patients. The coronary angiograms of one patient, who was a 63-year-old female, revealed coronary artery-to-pulmonary artery fistula originated from the left coronary artery with 3 aneurysms of 2 cm in diameter, respectively. The angiogram of another patient, who was a 77-year-old female, revealed coronary artery-to-pulmonary artery fistula originated from both coronary arteries with the giant aneurysm of 7 cm in diameter. We decided to operate by the reason of possibility of rupture of the aneurysms, and performed resection of the fistulas and the aneurysms with the closure of the drainage openings into the pulmonary artery with the aid of cardiopulmonary bypass. It was recommended to resect the coronary aneurysm before growing big in the patient with the coronary artery-to-pulmonary artery fistula.