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Ann Thorac Surg 1971;12:503-513
© 1971 The Society of Thoracic Surgeons

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Articles

Surgical Management of Congenital Coronary Artery Fistula

From the Department of Surgery, Duke University Medical Center, Durham, N.C.

^* Address reprint requests to Dr. Oldham, Department of Surgery, Duke University Medical Center, Durham, N.C. 27706.

Twelve patients with congenital coronary artery fistula are reported. Angina, heart failure, cardiomegaly, and electrocardiographic abnormalities were frequent findings. All patients had the fistula demonstrated angiographically, and the flow through the fistula in 8 patients produced an average pulmonary-to-systemic flow ratio of 2.2 to 1. Eleven patients had surgical closure of the fistula, and all survived with no evidence of subsequent myocardial ischemia. Relief of symptoms, reduction in heart size, and improvement in the electrocardiogram were documented postoperatively. Catheterization of a patient two years following obliteration of the fistula demonstrated normal size and function of a previously massively dilated coronary artery. The relief of symptoms, correction of hemodynamic abnormalities, low operative mortality, and threat of serious complications all emphasize the importance of surgical correction of this condition.

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