Surgical treatment of coronary artery-pulmonary artery fistula with coronary artery disease.

Coronary arteriovenous fistulae present rare clinical finding with the incidence of about 0.002% in the general population. Usually they are asymptomatic, but sometimes they can mimic other cardiac diseases, most commonly heart failure, myocardial ischemia, and endocarditis. Coronary arteriovenous fistulae have been reported to arise more commonly from the right coronary artery. Most of these fistulae are congenital, and only a small fraction acquired. In this report we present successful surgical treatment of coronary artery to pulmonary artery fistula combined with myocardial revascularization.